Individual
ANGI BLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 PIER 1 STE 204, ASTORIA, OR 97103-6328
(971) 350-3737
Mailing address
825 OLD HICKORY RD, GREENWOOD, MO 64034-9020
(270) 816-4092
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
12/27/2024
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