Black, Antoinette Marino

Black, Antoinette Marino is an sole proprietor health care provider with primary practice located at 9165 Otis Ave Ste 103 , Indianapolis IN 46216-2307. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Black, Antoinette Marino can be contacted via phone (317) 847-5697.

Contact Information

Primary practice address
9165 Otis Ave Ste 103 Indianapolis IN 46216-2307
Phone: (317) 847-5697
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 35001409A Indiana

Profile Details

NPI number 1518922038
LBN Legal business name Black, Antoinette Marino
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 18th, 2006
Last updated Apr 20th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518922038 NPPES
Indiana MEDICAID 100270530

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