Theresa Black, MA
NPI #1992289607 in San Clemente, California
Provider Information
- NPI Number
- 1992289607
- Entity Type
- Individual
- Name
- Theresa Black, MA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Marriage & Family Therapist
- Credential
- MA
- Enumeration Date
- Sep 18, 2018
- Last Updated
- Sep 18, 2018
Practice Location
- Address
- 2011 S EL CAMINO REAL
- City
- San Clemente
- State
- California
- ZIP Code
- 92672-3277
- Phone
- (949) 342-4070
Specialties & Taxonomy Codes
| Specialty |
|---|
| Marriage & Family Therapist |
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