NPI | 1619230208 |
---|---|
Former Legal Business Name | DAVID O BLACK PHD LLC |
Doing Business As | CAAT |
Entity Type | Organization |
Authorized Contact | DAVID O BLACK Owner 240-424-0184 |
Organization Subpart ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MD 04542) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC0700X Psychologist, Clinical (Licence: MD 04542) | |
Enumeration Date | 2012-06-19 |
Last Update Date | 2018-07-01 |