Individual
CATHY C BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3400 STOCKER DR, EVANSVILLE, IN 47720-6142
(812) 602-2919
Mailing address
5603 SAINT CHARLES DR, MOUNT VERNON, IN 47620-8324
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
31002868A
IN
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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