Individual
MRS. LEANNE M BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12183 W GRAND BLANC RD, DURAND, MI 48429-9308
(989) 737-9442
Mailing address
12183 W GRAND BLANC RD, DURAND, MI 48429-9308
(989) 737-9442
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362001412
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/07/2017
Last updated
08/29/2022
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