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Contact Information

AMY BLACK
2360 N 1450 E
MORONI, UT84646-0461
 Phone: 435-445-5520
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for AMY BLACK · (Female)

NPI # 1811354293
Status Active
Credentials
Entity Individual
Enumeration date 01/15/2016
Last updated 01/15/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • UT Medicaid 272503815
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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