Individual
MS. ELIZABETH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 SUN VALLEY DR, ROSWELL, GA 30076-5612
(678) 644-0039
(678) 669-2740
Mailing address
555 SUN VALLEY DR, ROSWELL, GA 30076-5612
(678) 644-0039
(678) 669-2740
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005480
GA
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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