Individual
JEANNE DEVO BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, LADC
Contact information
Practice address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5108
(405) 424-7711
Mailing address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5108
(405) 424-7711
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1022
OK
101YP2500X
Professional Counselor
2534
OK
Other
Enumeration date
05/12/2010
Last updated
10/22/2019
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