Individual
CHAVITA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11911 GREENVILLE AVE APT 3120, DALLAS, TX 75243-3675
(662) 392-4420
Mailing address
11911 GREENVILLE AVE APT 3120, DALLAS, TX 75243-3675
(662) 392-4420
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
119325
TX
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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