John W Black JR., MS, LPA
NPI #1457401945 in Georgetown, Kentucky
Provider Information
- NPI Number
- 1457401945
- Entity Type
- Individual
- Name
- John W Black JR., MS, LPA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Psychologist
- Credential
- MS, LPA
- Enumeration Date
- Jan 10, 2007
- Last Updated
- Jul 9, 2007
Practice Location
- Address
- 110 ROACH ST
- City
- Georgetown
- State
- Kentucky
- ZIP Code
- 40324-9393
- Phone
- (859) 253-1686
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist |
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