Black, Christine Marie
Black, Christine Marie is an sole proprietor health care provider with primary practice located at 1 Kwan Plz , Potosi MO 63664-1435. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Black, Christine Marie can be contacted via phone (573) 438-0751.Contact Information
Primary practice address
1 Kwan Plz
Potosi MO 63664-1435
Phone: (573) 438-0751
Fax: (573) 438-5460
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2008009619 | Missouri |
Profile Details
| NPI number | 1073814828 |
|---|---|
| LBN Legal business name | Black, Christine Marie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 10th, 2010 |
| Last updated | Dec 19th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073814828 | NPPES |
| Missouri | Other | 2008009619 | STATE LICENSE |
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