Black, Jeanette

Black, Jeanette is an individual health care provider with primary practice located at 29413 Russell St , Gold Beach OR 97444-7748. 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, Jeanette can be contacted via phone (541) 247-6566.

Contact Information

Primary practice address
29413 Russell St Gold Beach OR 97444-7748
Phone: (541) 247-6566
Fax: (541) 247-6549
Website:
Map and Directions

Health care specialties

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

Profile Details

NPI number 1174668875
LBN Legal business name Black, Jeanette
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2007
Last updated Oct 9th, 2019 - 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.

Request for update

Popular Providers