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Individual
MR. JAMES C. BLACK
Active
Individual
MR. JAMES C. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA CLINICAL PSY.
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1119
NC
106H00000X
Marriage & Family Therapist
0762
SC
Other
Enumeration date
03/27/2007
Last updated
01/05/2010
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