Individual
LATANYA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3125 66TH AVE N, BROOKLYN CENTER, MN 55429-1803
(763) 432-6868
(763) 432-6868
Mailing address
3125 66TH AVE N, BROOKLYN CENTER, MN 55429-1803
(763) 432-6868
(763) 432-6868
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MN
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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