Organization
DAN BLACK ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SPENCER BLACK CBA/FL (PRESIDENT)
(954) 290-9282
Entity
Organization
Contact information
Practice address
6030 NW 42ND AVE, COCONUT CREEK, FL 33073-3272
(954) 290-9282
(561) 853-2195
Mailing address
6030 NW 42ND AVE, COCONUT CREEK, FL 33073-3272
(954) 290-9282
(561) 853-2195
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0833
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
676044996
—
FL
Enumeration date
04/14/2011
Last updated
06/02/2016
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