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Shannon Lee Black
Addiction (Substance Use Disorder) Counselor in Victorville, California
NPI 1487377784

Shannon Lee Black is an Addiction (Substance Use Disorder) Counselor based in Barstow, CA and is specialized in Addiction (Substance Use Disorder). Shannon Lee Black practices in Victorville, CA. The NPI Number for Shannon Lee Black is 1487377784 and holds a License No. (California).

The current practice location address for Shannon Lee Black is 16248 Victor St, Victorville, CA and can be reached out via phone at 760-243-7151.

Location: 16248 Victor St, Victorville, CA, 92311-5476
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487377784
Provider Name
Shannon Lee Black
Credential
Provider Entity Type
Individual
Gender
Female
Address
16248 Victor St, Victorville, CA, 92311-5476
Phone Number
760-243-7151
Fax Number
Provider Enumeration Date
09/21/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
B3727585 01 CA SUBSTANCE USE DISORDER
institution
Provider Business Practice Location Address Details
Address
16248 Victor St
City
Victorville
State
California
Zip
92395-3934
Phone Number
760-243-7151
Fax Number
person
Provider Business Mailing Address Details
Address
16248 Victor St
City
Victorville
State
California
Zip
92395-3934
Phone Number
760-243-7151
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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