| NPI | 1285874081 |
|---|---|
| Former Name | JAN A BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E0001655) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E0001655) |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2009-03-06 |