Individual
CETA JANE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2096 E MAIN ST APT 21H, SPARTANBURG, SC 29307-1407
(336) 215-0864
Mailing address
2096 EAST MAIN STREET, 21H, SPARTANBURG, SC 29307-1407
(336) 215-0864
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
12/01/2025
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