Sophie Champagne Black
NPI #1093920522 in Kosciusko, Mississippi
Provider Information
- NPI Number
- 1093920522
- Entity Type
- Individual
- Name
- Sophie Champagne Black
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- May 10, 2007
- Last Updated
- Dec 29, 2009
Practice Location
- Address
- 310 AUTUMN RIDGE DR
- City
- Kosciusko
- State
- Mississippi
- ZIP Code
- 39090-3242
- Phone
- (662) 289-3499
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist |
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