Individual
TIARRA NICHELLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
447 S SHARON AMITY RD STE 140, CHARLOTTE, NC 28211-2888
(704) 900-9143
(704) 364-6267
Mailing address
447 S SHARON AMITY RD STE 140, CHARLOTTE, NC 28211-2888
(704) 900-9143
(704) 364-6267
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5441
NC
Other
Enumeration date
03/09/2019
Last updated
03/09/2019
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