Individual
CORNELIUS MARKEITH GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
218 DAFFODIL CIR, TALLAHASSEE, FL 32305-7072
(850) 445-1258
Mailing address
218 DAFFODIL CIR, TALLAHASSEE, FL 32305-7072
(850) 445-1258
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
FL
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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