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Individual

MRS. BRANDY DAVIS GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1007 PORTERS NECK RD., WILMINGTON, NC 28405
(910) 686-6506
(910) 686-6385
Mailing address
508 GREEN MEADOWS DR, WILMINGTON, NC 28405-3718
(910) 395-4823

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5102
NC

Other

Enumeration date
11/16/2007
Last updated
04/27/2011
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