| Doctor Name: | MRS. JENNIFER BLACK |
| NPI Number: | 1891195749 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, ALC |
| License Number: | C2121A |
| Business Practice Address: | 1518 Andrews Ave Ste D Ozark, AL - 363603716 |
| Business Phone Number: | 3347975880 |
| Business Fax Number: | 3344609758 |
| Mailing Address: | 1518 East Andrews Ave Sutie D, OZARK |
| State: | AL |
| Postal Code: | 36360 |
| Phone Number: | 3347975880 |
| Fax Number: | 3344609758 |
| NPI Enumeration Date: | 08/28/2014 |
| NPI Last Update Date: | 08/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | C2121A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |