Individual
EMILY ELROD-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, APCC
Contact information
Practice address
1181 MAIN ST, MORRO BAY, CA 93442-2005
(650) 207-3557
Mailing address
488 WOODLAND DR, LOS OSOS, CA 93402-3734
(650) 207-3557
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12004
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12004
BBS APCC
CA
Enumeration date
08/10/2022
Last updated
08/10/2022
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