Provider Demographics
NPI:1881492569
Name:BLACK, MICHELLE H
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:H
Last Name:BLACK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-8704
Mailing Address - Country:US
Mailing Address - Phone:828-280-7948
Mailing Address - Fax:
Practice Address - Street 1:17 HORSESHOE DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-8704
Practice Address - Country:US
Practice Address - Phone:828-280-7948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty