Individual
TASHA GILLET-GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1470 WALDRUN ST SE, PALM BAY, FL 32909-5996
(321) 848-5080
Mailing address
1470 WALDRUN ST SE, PALM BAY, FL 32909-5996
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12518
FL
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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