| Doctor Name: | MS. JOANNE BLACK |
| NPI Number: | 1760426142 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA LLP |
| License Number: | 6301007996 |
| Business Practice Address: | 447 1st St Menominee, MI - 498583307 |
| Business Phone Number: | 9068642590 |
| Business Fax Number: | 9068643307 |
| Mailing Address: | 447 1st St, MENOMINEE |
| State: | MI |
| Postal Code: | 498583307 |
| Phone Number: | 9068642590 |
| Fax Number: | 9068643058 |
| NPI Enumeration Date: | 06/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301007996 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |