Most Relevant Information
Provider Data
| NPI Number: | 1003507799 |
| Provider Name: | ELIZABETH RILEIGH BLACK |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/15/2023 |
| Last Updated: | 05/15/2023 |
Provider Practice Location
1981 LEWIS TURNER BLVD
FORT WALTON BEACH
FL
325471256
Practice Location Phone/Fax
| Phone: | 8508630818 |
| Fax: |
Provider Mailing Location
9900 N DAVIS HWY
PENSACOLA
FL
325148124
Provider Mailing Phone/Fax
| Phone: | 8506076910 |
| Fax: | 8506076932 |