Individual
CRYSTAL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 STUBBS DR, DAYTON, OH 45426
(937) 248-6469
Mailing address
102 STUBBS DR, DAYTON, OH 45426
(937) 248-6469
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
OH
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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