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NPI Profile for GEORGIA R BLACK in NEW BERLIN, WI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Art Therapist |
221700000X |
| NPI # | 1497378947 |
|
| Status | Active | |
| Credentials | MS | |
| Entity | Individual | |
| Enumeration date | 05/19/2020 | |
| Last updated | 01/18/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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GEORGIA R BLACK
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