Individual
RANDI BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1121 N COLLEGE PARK ST STE 200, DERBY, KS 67037-3639
(316) 351-8517
(316) 260-6494
Mailing address
1121 N COLLEGE PARK ST STE 200, DERBY, KS 67037-3639
(316) 351-8517
(316) 260-6494
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
2626
KS
106H00000X
Marriage & Family Therapist
Primary
2812
KS
Other
Enumeration date
08/28/2014
Last updated
01/13/2019
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