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Individual

MS. SHARLA BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS, LMT

Contact information

Practice address
4742 LIBERTY RD S # 189, SALEM, OR 97302-5037
(503) 428-8279
Mailing address
4742 LIBERTY RD, #189, SALEM, OR 97302
(503) 428-8279

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
4951
OR

Other

Enumeration date
06/19/2012
Last updated
06/19/2012
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