Individual
LYNDEE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
430 N MONTE VISTA ST, ADA, OK 74820-4610
(508) 421-1183
Mailing address
6551 PARK OF COMMERCE BLVD, BOCA RATON, FL 33487-8218
(800) 347-2264
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1045
OK
224Z00000X
Occupational Therapy Assistant
2005017458
MO
224Z00000X
Occupational Therapy Assistant
OTA 03939
OH
224Z00000X
Occupational Therapy Assistant
OTA 1747
CA
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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