Individual
MEGAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
40 29TH ST NE, PUYALLUP, WA 98372
(518) 420-2736
Mailing address
5016 FAIRWOOD BLVD NE APT 6, TACOMA, WA 98422-2170
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
60875784
WA
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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