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-- LEAH BLACK -- LCSW

Individual Provider (NPI-1) Active

Social Worker, Clinical

Provider Information

NPI Number
1003107731
Provider Type
Individual Provider (NPI-1)
Credentials
LCSW
Status
Active

Contact & Location

Address
310 E BROADWAY AVE, JACKSON, WY, 830018636
Phone
(307) 654-7003
Fax
(307) 224-4973

Specialties & Taxonomies

Social Worker, Clinical Primary License: WY #LCSW-742

All Addresses

MAILING

PO BOX 13572

JACKSON, WY, 830023572

(307) 654-7003

LOCATION

310 E BROADWAY AVE

JACKSON, WY, 830018636

(307) 654-7003