Individual
DR. JUDITH LYNN BLACK
Active
Individual
DR. JUDITH LYNN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002873
VA
103TC0700X
Clinical Psychologist
3019
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046WJ
BLUE CROSS/BLUE SHIELD
NC
01
—
2117520
CIGNA
NC
05
—
6000829
—
NC
Enumeration date
06/08/2006
Last updated
02/02/2023
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