Individual
SOPHIA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
311 SIMPSON RD, ANDERSON, SC 29621-2157
(864) 261-3875
Mailing address
3025 CHESBROUGH BLVD, ROCK HILL, SC 29732-8078
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2745
SC
Other
Enumeration date
02/20/2008
Last updated
11/04/2022
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