Search › Michigan › 225XP0200X
Deronda Black, OTR
NPI 1316114150 · on the registry since 2008 · sole proprietor
Practice
- Address
- 14416 Portage Rd
Vicksburg, MI 49097 - Phone
- (269) 649-1848
- Fax
- (269) 649-1848
Registry record
- Primary taxonomy
- 225XP0200X
225XP0200X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2008-05-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan