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Individual

MRS. FLOANNA BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, TLLP

Contact information

Practice address
19853 OUTER DR STE 110, DEARBORN, MI 48124-2044
(313) 406-5056
(313) 908-9181
Mailing address
10601 MOUNT VERNON ST APT 202, TAYLOR, MI 48180-6910
(313) 926-3567

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301017194
MI
247200000X
Other Technician
Primary

Other

Enumeration date
06/20/2016
Last updated
06/15/2021
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