Individual
MRS. AUDREY EVERETT BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1200 W 2ND ST, FORT STOCKTON, TX 79735-6432
(806) 778-8326
Mailing address
1200 W 2ND ST, FORT STOCKTON, TX 79735-6432
(806) 778-8326
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
101106
TX
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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