Individual
AUDREY MARIE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 808-8802
Mailing address
5765 ORIOLE CT, CINCINNATI, OH 45227-3536
(513) 240-1483
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005824A
IN
Other
Enumeration date
02/10/2015
Last updated
04/01/2024
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