Individual
JENNIFER BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
916 NW 42ND ST, OKLAHOMA CITY, OK 73118-6805
(812) 369-1961
Mailing address
916 NW 42ND ST, OKLAHOMA CITY, OK 73118-6805
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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