Individual
MS. HEATHER WITTMANN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5095 BEATLINE RD, LONG BEACH, MS 39560-3814
(228) 223-2205
Mailing address
222 BOGGS CIR, LONG BEACH, MS 39560-5807
(228) 223-2205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C5680
MS
Other
Enumeration date
02/01/2010
Last updated
12/17/2024
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