Individual
MRS. WENDIE G BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3490 E. RIO VIRGIN RD., LITTLEFIELD, AZ 86432
(928) 347-5486
(928) 347-5967
Mailing address
3490 E. RIO VIRGIN RD., LITTLEFIELD, AZ 86432
(928) 347-5486
(928) 347-5967
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
3041974
AZ
Other
Enumeration date
11/19/2011
Last updated
11/19/2011
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