Individual
MRS. JILLIAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., ED.S.
Contact information
Practice address
755 WESTERN ROW ROAD, WESTERN ROW ELEMENTARY, MASON, OH 45040
(513) 398-5821
Mailing address
6656 FOUNTAINS BLVD UNIT 7, WEST CHESTER, OH 45069-6128
(330) 933-2766
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
21027332
OH
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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