Individual
KIKI TAMIKA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
603 HAMILTON RD, SOUTH ORANGE, NJ 07079-2709
(201) 912-3085
Mailing address
603 HAMILTON RD, SOUTH ORANGE, NJ 07079-2709
(201) 912-3085
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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