Most Relevant Information
Provider Data
| NPI Number: | 1003385162 |
| Provider Name: | AMY R BLACK |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/19/2018 |
| Last Updated: | 11/19/2018 |
Provider Practice Location
84 ROUTE 59 STE 102
SUFFERN
NY
109014910
Practice Location Phone/Fax
| Phone: | 7186506540 |
| Fax: |
Provider Mailing Location
84 ROUTE 59 STE 102
SUFFERN
NY
109014910
Provider Mailing Phone/Fax
| Phone: | 7186506540 |
| Fax: |