Individual
STEPHANIE FRANCES BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
409 AVENUE C, APT 1A, BROOKLYN, NY 11218-4525
(917) 734-6537
Mailing address
409 AVENUE C, APT 1A, BROOKLYN, NY 11218-4525
(917) 734-6537
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9516327
NY
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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