Black, Mary

Black, Mary is an individual health care provider with primary practice located at 1427 Oakland St , Saint Clair MI 48079-5122. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Black, Mary can be contacted via phone (810) 650-5902.

Contact Information

Primary practice address
1427 Oakland St Saint Clair MI 48079-5122
Fax: (800) 305-6764
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1750823456
LBN Legal business name Black, Mary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2016
Last updated Nov 11th, 2016 - about 8 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 1750823456 NPPES
Michigan Other 81-4065881 FEIN

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