Individual
MS. SHAREASE A GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
227 IDYLWILD ST NE, WARREN, OH 44483-3431
(330) 469-7707
Mailing address
227 IDYLWILD ST NE, WARREN, OH 44483-3431
(330) 469-7707
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400712730108
OH
Other
Enumeration date
08/06/2012
Last updated
10/16/2012
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