Individual
SHARON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
1774 SHERIDAN AVE, SAINT PAUL, MN 55116-2730
(763) 222-7362
Mailing address
1774 SHERIDAN AVE, SAINT PAUL, MN 55116-2730
(763) 222-7362
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2016
Last updated
02/19/2020
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