Individual
ANNA M BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
106 THREE RIVERS N, FORT WAYNE, IN 46802-1312
(260) 426-5778
(260) 423-6412
Mailing address
106 THREE RIVERS NORTH, FORT WAYNE, IN 46802
(260) 426-5778
(260) 423-6412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000048
IN
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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