Individual
TANYA RENAE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
3192 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-2239
(928) 288-0500
Mailing address
548 LINCOLN DR, CLARKDALE, AZ 86324-3347
(928) 399-8390
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28466
AZ
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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