Individual
KATHERINE MARIE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2400 MARYLAND RD STE 20, WILLOW GROVE, PA 19090-1732
(800) 321-9999
Mailing address
1 PARKER AVE APT 2306, PHILADELPHIA, PA 19128-4464
(703) 606-8730
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC016269
PA
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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