Individual
ERIN RICARD BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
101 13TH STREET, HUNTINGTON, WV 25701
(304) 525-7622
Mailing address
101 13TH STREET, HUNTINGTON, WV 25701
(304) 525-7622
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1772
WV
Other
Enumeration date
09/11/2012
Last updated
10/17/2012
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