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JEANNEKA BLACK
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1326415233
Individual Registrant: JEANNEKA BLACK
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
4001 COMMERCIAL CENTER DR STE 2 MARION, AR 72364-9616 US
Tel: 870-732-7920 Fax: 870-732-7923
Tel: 870-732-7920 Fax: 870-732-7923
Contact information for business:
2809 FOREST HOME RD JONESBORO, AR 72401-5320 US
Tel: 866-972-1268 Fax: --
Tel: 866-972-1268 Fax: --
Registration Information:
NPI: 1326415233
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health | AR |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
