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Individual

MR. TIMOTHY SCOTT BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
9304 FOREST LN, SUITE 161 NORTH, DALLAS, TX 75243-6238
(214) 342-5800
Mailing address
9304 FOREST LN, SUITE 161 NORTH, DALLAS, TX 75243-6238
(214) 342-5800

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
24658
TX

Other

Enumeration date
04/15/2016
Last updated
04/15/2016
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