Individual
MS. LAUREN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1361 JEFFERSON DR APT E, FLORENCE, SC 29501
(845) 325-9704
Mailing address
1361 JEFFERSON DR APT E, FLORENCE, SC 29501-5359
(845) 325-9704
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
015179
NY
225X00000X
Occupational Therapist
Primary
5643
SC
Other
Enumeration date
03/20/2012
Last updated
11/18/2019
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