Individual
MS. MITZI GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1500 SAWMILL RD, RALEIGH, NC 27615-4320
(919) 848-7284
Mailing address
165 BUCHANAN LN, CLAYTON, NC 27527-5766
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2354
NC
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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