Individual
JACQUELINE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4019 18TH ST S, ARLINGTON, VA 22204-5141
(703) 967-9981
Mailing address
4703 W BRADDOCK RD APT 30, ALEXANDRIA, VA 22311-4706
(814) 233-1450
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005764
VA
Other
Enumeration date
12/20/2016
Last updated
05/21/2024
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