Individual
SHELLY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3021 W HORIZON RIDGE PKWY, HENDERSON, NV 89052-3990
(702) 646-5000
(702) 617-2084
Mailing address
10325 JUNIPER CREEK LN, LAS VEGAS, NV 89145-8853
(907) 617-2415
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5643-C
NV
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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