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

Michael David Black, OTR/L

Individual provider Occupational Therapist · NPI 1104488816

Michael David Black, OTR/L is an Occupational Therapist in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2019.

Licensed in
ID
In the registry since
2019
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

600 N Robbins Rd
Boise, ID 83702-4565
Phone: (208) 489-4444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT-2071 (ID)

Record details

NPI number1104488816
Entity typeIndividual (Type 1)
GenderMale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedJuly 2, 2019
Last updated in NPPESJuly 2, 2019

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