Individual
CAMILLA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3545 N VERMILION ST, DANVILLE, IL 61832-1100
(217) 651-6801
Mailing address
3545 N VERMILION ST, DANVILLE, IL 61832-1100
(217) 651-6801
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
150113474
IL
Other
Enumeration date
05/04/2024
Last updated
05/04/2024
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