Individual
CHERYL ANN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1890 VISTA SIERRA CT, LAS CRUCES, NM 88005-4653
(575) 639-4200
(575) 523-7106
Mailing address
1890 VISTA SIERRA CT, LAS CRUCES, NM 88005-4653
(575) 639-4200
(575) 523-7106
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
647
NM
103TS0200X
School Psychologist
647
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J1735
—
NM
Enumeration date
02/27/2007
Last updated
07/24/2015
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