Individual
ELIZABETH ANNE RENEE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
1000 HASTINGS ST, TRAVERSE CITY, MI 49686-3445
(231) 947-8110
(231) 947-3522
Mailing address
1000 HASTINGS ST, TRAVERSE CITY, MI 49686-3445
(231) 947-8110
(231) 947-3522
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401013136
MI
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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