Individual
DR. MARYLYNNE KEMPERMAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
642 COWPATH ROAD #393, LANSDALE, PA 19446
(215) 361-6959
(215) 361-6195
Mailing address
621 HILDEBRANDT ROAD, PERKIOMENVILLE, PA 18074-9504
(610) 754-7608
(610) 754-7608
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
TPS 029985
PA
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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