Individual
REBECCA M BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
20 WEST PARK ST, SUITES 416 AND 219, LEBANON, NH 03766
(603) 448-1101
(603) 448-8249
Mailing address
9 HANOVER ST, SUITE 2 WEST CENTRAL SERVICES INC, LEBANON, NH 03766
(603) 448-0126
(603) 448-6001
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0480000202
VT
103T00000X
Psychologist
Primary
362
NH
103T00000X
Psychologist
472
MA
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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