Individual
CAROL LYNN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
950 THISTLE MEADE CIR, BURLESON, TX 76028-6799
(817) 995-8625
Mailing address
950 THISTLE MEADE CIR, BURLESON, TX 76028-6799
(817) 995-8625
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
528145
TX
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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