Individual
COURTNEY LAINE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASE MANAGEMENT
Contact information
Practice address
1201 ARLINGTON ST STE G, ADA, OK 74820-4072
(580) 235-0274
Mailing address
1201 ARLINGTON ST STE G, ADA, OK 74820-4072
(580) 235-0274
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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