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Individual

MRS. ABBY BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, CDE

Contact information

Practice address
511 RENAISSANCE DR, SUITE 130, SAINT JOSEPH, MI 49085-2180
(269) 350-9789
Mailing address
717 SAINT JOSEPH DR, STE 140, SAINT JOSEPH, MI 49085-2428
(269) 369-2347

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
875262

Other

Enumeration date
09/19/2012
Last updated
10/31/2016
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