Individual
MRS. MARIAN RUTH BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
507 MECHEM DR, RUIDOSO, NM 88345-6902
(575) 257-9217
(575) 257-6989
Mailing address
223 RIO ST, RUIDOSO, NM 88345-7401
(575) 937-2611
(575) 257-6989
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
40529
TX
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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