Individual provider · Type 1 NPI
Misty Renae Black, PTA
Physical Therapy Assistant · Sebastopol, CA
Practice location
100 Pleasant Hill Ave N
Sebastopol, CA 95472-3104
Fax (707) 829-3287
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | AT6901 (CA) |
| Physical Therapist | 225100000X | AT6901 (CA) |
Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …
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About NPI 1043386220
Misty Renae Black, PTA's National Provider Identifier is 1043386220, issued on Nov 28, 2006. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Sebastopol, CA. The record was last updated on Mar 1, 2022.