Individual
KRISTEN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
6317 HIGHWAY 329, CRESTWOOD, KY 40014-9040
(502) 384-0910
Mailing address
3520 DUTCHMANS LN, LOUISVILLE, KY 40205-3256
(317) 366-3398
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R5722
KY
Other
Enumeration date
10/04/2013
Last updated
10/04/2013
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