| Alesia Black | |
|
5224 Olympic Dr Ste 214 Gig Harbor WA 98335-1792 | |
| (253) 300-0394 | |
| (253) 313-0570 |
| Full Name | Alesia Black |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5224 Olympic Dr Ste 214, Gig Harbor, Washington |
| Authorized Official Name and Position | Alesia A Black (OWNER) |
| Authorized Official Contact | 2533000394 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alesia Black 5224 Olympic Dr Ste 214 Gig Harbor WA 98335-1792 Ph: (253) 300-0394 | Alesia Black 5224 Olympic Dr Ste 214 Gig Harbor WA 98335-1792 Ph: (253) 300-0394 |
| NPI Number | 1780856906 |
|---|---|
| Provider Enumeration Date | 03/27/2008 |
| Last Update Date | 12/21/2021 |
| Certification Date | 11/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780856906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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