Individual
MRS. JENNIFER BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
5334 HORNET AVE, BEECH GROVE, IN 46107-2306
(317) 780-5050
Mailing address
5334 HORNET AVE, BEECH GROVE, IN 46107-2306
(317) 780-5050
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1567410
IN
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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