Individual
LEAH BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 KINGS CROSSING CT, SAINT LOUIS, MO 63129-5064
(618) 530-2395
Mailing address
11 KINGS CROSSING COURT, ST. LOUIS, MO 63129
(618) 530-2395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2014012995
MO
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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