KELLY BLACK

FAYETTEVILLE, NC
NPI1942550405
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: NC  11328)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: IL  056.009759)
Enumeration Date2012-09-12
Last Update Date2020-09-17
Business Address
KELLY BLACK OTR/L
4101 RAEFORD RD
FAYETTEVILLE, NC 28304-4114
Phone number: 910-488-2120
Mailing Address
KELLY BLACK OTR/L
1041 PARKERS RIDGE DR
FUQUAY VARINA, NC 27526-5892
Phone number: