Black, Kaneisha

Black, Kaneisha is an sole proprietor health care provider with primary practice located at 710 Wildlife Ln , Columbia SC 29209-3464. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Black, Kaneisha can be contacted via phone (704) 763-7479.

Contact Information

Primary practice address
710 Wildlife Ln Columbia SC 29209-3464
Phone: (704) 763-7479
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X

Profile Details

NPI number 1609625201
LBN Legal business name Black, Kaneisha
Credentials PSY.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 15th, 2024
Last updated May 15th, 2024 - about 2 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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