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Individual

PAMELLA BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-4926
Mailing address
1116 W GROVERS AVE, PHOENIX, AZ 85023-2639
(602) 513-2795

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary

Other

Enumeration date
08/14/2018
Last updated
08/14/2018
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