JOHANNA BLACK
Individual Provider (NPI-1)
Active
Counselor, Professional
Provider Information
- NPI Number
1619854981- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 417 COMMERCIAL ST STE 5, EMPORIA, KS, 668014080
- Phone
- (620) 412-7770
Specialties & Taxonomies
Counselor, Professional
Primary License: KS #05079
All Addresses
MAILING
915 OXFORD DR
EMPORIA, KS, 668015438