Karen Anne Black, OTR/L
Occupational Therapist in Ithaca, NY. Individual provider (NPI-1).
NPI number1104075449
StatusActive
Last updated in NPPESSep 17, 2015
Details
- NPI
- 1104075449
- Entity type
- Individual (NPI-1)
- Name
- Ms. Karen Anne Black
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 11, 2008
- Last updated
- Sep 17, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | 010623-1 | NY | Yes |
Practice location
555 Warren RdIthaca, NY 14850-1862
Phone 607-257-1551
Mailing address
555 Warren RdIthaca, NY 14850-1862
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