Mallory L Black

NPI #1578359212 in Poquoson, Virginia

Provider Information

NPI Number: 1578359212
Entity Type: Individual
Name: Mallory L Black
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 18, 2025
Last Updated: Apr 18, 2025

Practice Location

Address: 241 DARDEN DR
City: Poquoson
State: Virginia
ZIP Code: 23662-1215
Phone: (757) 356-2242

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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