Individual
MR. MICHAEL ANTHONY BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.F.T.
Contact information
Practice address
1313 E MAPLE ST, BELLINGHAM, WA 98225-5708
(360) 510-9645
(360) 685-4222
Mailing address
2625 PACIFIC HIGHLANDS AVE, FERNDALE, WA 98248-8609
(360) 510-9645
(360) 685-4200
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF60160766
WA
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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