| Doctor Name: | DR. DAVID O BLACK |
| NPI Number: | 1801044896 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 04542 |
| Business Practice Address: | 8720 Georgia Ave Suite 300 Silver Spring, MD - 209103638 |
| Business Phone Number: | 3015650534 |
| Business Fax Number: | 3015652217 |
| Mailing Address: | 3610 39th St Nw, A541 WASHINGTON |
| State: | DC |
| Postal Code: | 200165505 |
| Phone Number: | 6177772399 |
| Fax Number: | |
| NPI Enumeration Date: | 09/03/2008 |
| NPI Last Update Date: | 09/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103G00000X |
| License Number: | 04542 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Clinical Neuropsychologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |