Individual
DR. TAYLOR MICHELLE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2220 WASHINGTON AVE, CONWAY, AR 72032-2762
(501) 679-0232
Mailing address
540 CHERUB DR, CONWAY, AR 72034-3363
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
202118
AR
Other
Enumeration date
10/02/2021
Last updated
10/29/2022
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