MS. Sionag M Black, PHD

NPI #1821049412 in Beaver Dam, Wisconsin

Provider Information

NPI Number: 1821049412
Entity Type: Individual
Name: MS. Sionag M Black, PHD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Clinical
Credential: PHD
Enumeration Date: May 16, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 200 FRONT STREET
Address 2: SUITE 3D
City: Beaver Dam
State: Wisconsin
ZIP Code: 53916
Phone: (920) 885-2780

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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