Individual
AMANDA LEE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
381 CAMP ST, FRANKLIN FURNACE, OH 45629-7503
(740) 574-1315
(740) 876-4650
Mailing address
250 NEW HOPE ROAD, LUCASVILLE, OH 45648
(740) 464-4017
(740) 876-4650
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA007193
OH
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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