Individual
STACY A GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6480 NEW HAMPSHIRE AVE, TAKOMA, MD 20912
(301) 326-4607
Mailing address
6480 NEW HAMPSHIRE AVE, TAKOMA PARK, MD 20912-4716
(202) 326-4607
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
05/29/2012
Last updated
10/26/2023
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