Individual
LANCE H BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
455 N LIGHT PLANT RD, AZTEC, NM 87410-1517
(505) 334-6102
Mailing address
4 ROAD 3459, FLORA VISTA, NM 87415-9667
(505) 278-3400
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
SWB-2025-0657
NM
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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