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Individual

CARRIE JEANNE BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ASSOC.

Contact information

Practice address
1332 WOODMAN DR, DAYTON, OH 45432-3439
(513) 470-1001
Mailing address
700 DENNISON AVE, DAYTON, OH 45417-3221
(513) 787-4890

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
2084P0804X
OH
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2084P0804X
OH

Other

Enumeration date
12/22/2025
Last updated
01/15/2026
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