Kelly Black

NPI #1871471177 in Chardon, Ohio

Provider Information

NPI Number: 1871471177
Entity Type: Individual
Name: Kelly Black
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Aug 25, 2025
Last Updated: Aug 25, 2025

Practice Location

Address: 12557 RAVENWOOD DR
City: Chardon
State: Ohio
ZIP Code: 44024-9009
Phone: (440) 285-3568

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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