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MELINDA ACOSTA BLACK LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1962056820

Individual Registrant:
 MELINDA  ACOSTA BLACK LCSW
Gender: F
Sole Proprietor

Location and contact information for practice:
1526 BROOKHOLLOW DRIVE  SANTA ANA, CA 92705 US
Tel: 714-545-3390  Fax: --

Contact information for business:
6070 E CAMINO CORRER  ANAHEIM, CA 92807-3213 US
Tel: 714-366-3419  Fax: --

Registration Information:
NPI: 1962056820
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
CA88773

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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