Individual
AMANDA M BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
499 W 4TH AVE, EUGENE, OR 97401-2505
(541) 505-5188
Mailing address
1770 W 13TH AVE, EUGENE, OR 97402-3721
(541) 232-8626
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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