Deronda Ann Black, OTR Valid NPI

Individual provider · Pediatric Occupational Therapist · Vicksburg, MI

NPI

1316114150

Type

Individual (Type 1)

Primary specialty

Pediatric Occupational Therapist (Occupational Therapist)

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225XP0200X

License number

31004281A (IN)

Sex

Female

Sole proprietor

Yes

Enumerated

2008-05-12

Last updated

2008-05-12