Individual
JOHANNA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 COMMERCIAL ST STE 5, EMPORIA, KS 66801-4080
(620) 412-7770
Mailing address
915 OXFORD DR, EMPORIA, KS 66801-5438
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
05079
KS
Other
Enumeration date
08/19/2025
Last updated
02/11/2026
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