Individual
DOMINIQUE CHANTEL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
1157 E 25TH AVE, COLUMBUS, OH 43211-2113
(614) 687-9539
Mailing address
296 E 17TH AVE APT 2A, COLUMBUS, OH 43201-1707
(614) 209-8641
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/25/2024
Last updated
05/30/2024
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