Individual
JODI LYN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMHC
Contact information
Practice address
184 E PARADISE CT, SARATOGA SPRINGS, UT 84045-4504
(801) 678-3971
Mailing address
184 E PARADISE CT, SARATOGA SPRINGS, UT 84045-4504
(801) 678-3971
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3504286004
UT
Other
Enumeration date
09/04/2018
Last updated
09/20/2022
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