Derek John Black
Case Manager/Care Coordinator in Logan, UT. Individual provider (NPI-1).
NPI number1679231237
StatusActive
Last updated in NPPESDec 1, 2021
Details
- NPI
- 1679231237
- Entity type
- Individual (NPI-1)
- Name
- Derek John Black
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 1, 2021
- Certification date
- Dec 1, 2021
- Last updated
- Dec 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
475 W 1465 N Apt 103Logan, UT 84341-6619
Phone 435-851-3813
Mailing address
475 W 1465 N Apt 103Logan, UT 84341-6619
Phone 435-851-3873
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All 86 Case Manager/Care Coordinator providers in Logan · All 1,815 providers in Logan
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