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Individual

BUCK J BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
100 SAW MILL RD, STE 3102, LAFAYETTE, IN 47905-5592
(765) 807-6778
(765) 807-6778
Mailing address
100 SAW MILL RD, STE 3102, LAFAYETTE, IN 47905-5592
(765) 807-6778
(765) 807-6778

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33005111A
IN

Other

Enumeration date
04/28/2008
Last updated
08/06/2023
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