Individual
ELIZABETH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3722 KATELLA AVE STE C, LOS ALAMITOS, CA 90720-3102
(562) 270-2970
Mailing address
1863 W RANDOM DR, ANAHEIM, CA 92804-2664
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18322
CA
Other
Enumeration date
07/31/2023
Last updated
10/23/2023
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