Individual
CARLA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19335 CENTRALIA, REDFORD, MI 48240-1410
(313) 648-5208
Mailing address
19335 CENTRALIA, REDFORD, MI 48240-1410
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401013957
MI
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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