Individual
LAURA VANESSA GREEN I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3042 MCKINLEY AVE, COLUMBUS, OH 43204-3653
(614) 487-7805
(614) 487-7809
Mailing address
7605 BEECHLAKE DR, COLUMBUS, OH 43235-1603
(614) 975-1352
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/17/2020
Last updated
10/17/2020
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