Individual
LAURA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25604 STATE HIGHWAY 112, CAMERON, OK 74932-2612
(479) 252-0707
Mailing address
25604 STATE HIGHWAY 112, CAMERON, OK 74932-2612
(479) 252-0707
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/14/2026
Last updated
05/14/2026
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