Individual
MS. CAROL ANN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
903 E CYPRESS CREEK RD, FT LAUDERDALE, FL 33334-4116
(954) 491-2225
(954) 491-6862
Mailing address
1419 S 24TH CT, HOLLYWOOD, FL 33020-5803
(954) 696-4978
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA33170
MASSAGE THERAPY LICENSE
FL
Enumeration date
08/02/2008
Last updated
08/02/2008
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