Individual
ELICIA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2518 VALLEY FOREST DR, MISSOURI CITY, TX 77489-6005
(281) 299-8404
Mailing address
2518 VALLEY FOREST DR, MISSOURI CITY, TX 77489-6005
(281) 299-8404
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
7479
TX
Other
Enumeration date
10/18/2016
Last updated
04/26/2024
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