Individual
MR. STANLEY MARKAY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, BSN, MPA
Contact information
Practice address
4411 E KINGS CANYON RD, FRESNO, CA 93702-3604
(559) 453-6616
Mailing address
1161 GREENFIELD AVE, CLOVIS, CA 93611-8596
(559) 299-9091
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
562325
CA
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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