Individual
DR. JANIE E BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1600 W 38TH ST STE 212, AUSTIN, TX 78731-6405
(512) 324-3315
(512) 324-3314
Mailing address
1600 W 38TH ST STE 212, AUSTIN, TX 78731-6405
(512) 324-3315
(512) 324-3314
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
36256
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325199301
—
TX
05
—
325199302
—
TX
Enumeration date
10/09/2012
Last updated
01/29/2015
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