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Individual

AMY BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDP-T

Contact information

Practice address
2601 SUMMIT AVE, EVERETT, WA 98201-3309
(425) 252-2131
(425) 258-1725
Mailing address
PO BOX 12598, EVERETT, WA 98206-2598
(425) 252-2131
(425) 258-1725

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO 60668826
WA

Other

Enumeration date
08/12/2016
Last updated
08/12/2016
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