Individual
VICTORIA LEOLA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
655 E BURKITT ST, SHERIDAN, WY 82801-4401
(307) 674-6343
Mailing address
655 E BURKITT ST, SHERIDAN, WY 82801-4401
(307) 674-6343
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
WY
Other
Enumeration date
02/17/2007
Last updated
07/08/2007
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