Individual
DR. MARY WARD BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
320 LESTER HALL, UNIVERSITY, MS 38677
(901) 826-3644
Mailing address
86 TUSCAN HILLS DR, OXFORD, MS 38655-9269
(901) 826-3644
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
581026
MS
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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