Individual
GABRIEL G BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPE
Contact information
Practice address
1658 HWY 371 WEST, PRESCOTT, AR 71857
(870) 887-3660
(870) 887-3705
Mailing address
2904 ARKANSAS BLVD, TEXARKANA, AR 71854-2536
(870) 773-4655
(870) 772-4650
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
09-63AE-PL
AR
171M00000X
Case Manager/Care Coordinator
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—
Other
Enumeration date
03/09/2007
Last updated
03/08/2010
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