Individual
JOSEPH EDWARD BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
731 E MAIN ST, SUITE 13, JACKSON, OH 45640-2100
(740) 286-8789
(740) 286-8789
Mailing address
1328 CREMEENS RD, PATRIOT, OH 45658-9319
(740) 256-6442
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
4889
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2047529
—
OH
Enumeration date
01/12/2007
Last updated
11/22/2011
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