Alexis Dawn Black
NPI #1588315113 in Charleston, Illinois
Provider Information
- NPI Number
- 1588315113
- Entity Type
- Individual
- Name
- Alexis Dawn Black
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor
- Enumeration Date
- Jan 14, 2022
- Last Updated
- Jan 14, 2022
Practice Location
- Address
- 1836 VICTORIA LN
- City
- Charleston
- State
- Illinois
- ZIP Code
- 61920-2964
- Phone
- (217) 508-8080
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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