Individual
NATALIE LEA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
511 N AVON ST, ROCKFORD, IL 61101-5829
(563) 210-7471
Mailing address
511 N AVON ST, ROCKFORD, IL 61101-5829
(563) 210-7471
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004594
IL
Other
Enumeration date
01/15/2020
Last updated
09/13/2022
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