Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Deronda Ann Black, OTR

Individual provider Pediatric Occupational Therapist · NPI 1316114150

Deronda Ann Black, OTR is a Pediatric Occupational Therapist in Vicksburg, Michigan. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2008
What do these letters mean?
OTR — Occupational Therapist, Registered
A nationally registered occupational therapist.

See every abbreviation used in this directory →

Practice location Address checks out

14416 Portage Rd
Vicksburg, MI 49097-9732
Phone: (269) 649-1848
Fax: (269) 649-1848
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence 31004281A (IN)

Record details

NPI number1316114150
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR
Sole proprietorYes
NPI enumeratedMay 12, 2008
Last updated in NPPESMay 12, 2008