Individual
KIRK L BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, THERAPIST
Contact information
Practice address
396 KITZMILLER RD, GRAY, TN 37615-2202
(901) 596-2233
Mailing address
396 KITZMILLER RD, GRAY, TN 37615-2202
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/20/2025
Last updated
06/20/2025
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