| NPI | 1992341952 |
|---|---|
| Former Name | ANNETTE DANNIELLE BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: KS 18-00798) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |