Individual
MS. LOU ANNE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
111 S RAILROAD AVE, DUNN, NC 28334-4853
(910) 892-0027
(910) 892-0029
Mailing address
111 S RAILROAD AVE, DUNN, NC 28334-4853
(910) 892-0027
(910) 892-0029
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2083
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0777Y
BCBS
NC
05
—
720777Y
—
NC
Enumeration date
04/30/2008
Last updated
04/12/2011
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