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Individual

DORIS KAY BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
39 MURRAY GUARD DR, JACKSON, TN 38305-3610
(731) 736-4400
Mailing address
39 MURRAY GUARD DR, JACKSON, TN 38305-3610
(731) 736-4400

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
TN
104100000X
Social Worker
12599
TN

Other

Enumeration date
07/02/2018
Last updated
10/02/2024
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