Individual
DANIELLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 SANDCREST BLVD, COLUMBUS, IN 47203-3053
(812) 374-4845
Mailing address
2600 SANDCREST BLVD, COLUMBUS, IN 47203-3053
(812) 374-4845
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-200254
IN
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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