Individual
JENNA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS, CBIS. ATRIC
Contact information
Practice address
28328 N SKYE DR, FARMINGTON HILLS, MI 48334-5335
(586) 709-8966
Mailing address
28328 N SKYE DR, FARMINGTON HILLS, MI 48334-5335
(586) 709-8966
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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