| Travis Black, | |
|
735 S 200 W Ste 1, Blanding, UT 84511-3923 | |
| (435) 678-2992 | |
| (435) 678-3116 |
| Full Name | Travis Black |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 735 S 200 W Ste 1, Blanding, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356997134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Travis Black, 735 S 200 W Ste 1, Blanding, UT 84511-3923 Ph: (435) 678-2992 | Travis Black, 735 S 200 W Ste 1, Blanding, UT 84511-3923 Ph: (435) 678-2992 |
Brittney King, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 75 E 800 N, Blanding, UT 84511 Phone: 208-881-7161 | |
Generra Blake, Counselor Medicare: Not Enrolled in Medicare Practice Location: 735 S 200 W Ste 1, Blanding, UT 84511 Phone: 435-678-2992 Fax: 435-678-3116 | |
Joanna K. Bethea, Counselor Medicare: Not Enrolled in Medicare Practice Location: 987 N 100 W, Blanding, UT 84511 Phone: 435-260-1318 |