Individual
DEBBY BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
104 B. WEST JACKSON STREET, BOLIVAR, MO 65613
(417) 777-1458
Mailing address
519 E CANTEBURY ST, SPRINGFIELD, MO 65810-2603
(417) 459-6591
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2004032564
MO
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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