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Individual

MS. AMY LOUISE BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DT

Contact information

Practice address
6448 N OAK PARK AVE, 2N, CHICAGO, IL 60631-2018
(847) 347-6283
Mailing address
6448 N OAK PARK AVE, 2N, CHICAGO, IL 60631-2018
(847) 347-6283

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
AB46220100P
IL

Other

Enumeration date
02/26/2007
Last updated
09/25/2015
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