Individual
LESA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
9725 SE 36TH ST, SUITE 205, MERCER ISLAND, WA 98040-3841
(206) 232-2046
(206) 232-1096
Mailing address
9725 SE 36TH ST, SUITE 205, MERCER ISLAND, WA 98040-3841
(206) 232-2046
(206) 232-1096
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00002959
WA
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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