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Contact Information

TERESA L BLACK
800 NORTH SIXTH STREET
RIVERDALE ELEMENTARY SCHOOL
MUSCODA, WI53573
 Phone: 608-739-3101
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for TERESA L BLACK · (Female)

NPI # 1417265059
Status Active
Credentials
Entity Individual
Enumeration date 09/16/2010
Last updated 09/16/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 66-27
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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