Individual
MRS. DENISE LEE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
389 GREEN STREET, LOCKPORT, NY 14094
(716) 478-4925
(716) 478-4730
Mailing address
389 GREEN ST, ROOM 128, LOCKPORT, NY 14094-2013
(716) 478-4725
(716) 478-4730
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002530-1
NY
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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