Individual
EVELYN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4030 E HAZELWOOD ST, PHOENIX, AZ 85018-3745
(612) 345-0074
Mailing address
945 N CENTRAL AVE, WOODMERE, NY 11598-1604
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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