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Individual

DESTINY GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
418 OLD FORGE RD, CHAPIN, SC 29036-9753
(919) 805-2098
Mailing address
418 OLD FORGE RD, CHAPIN, SC 29036-9753
(919) 805-2098

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-392954
CO

Other

Enumeration date
11/26/2024
Last updated
11/26/2024
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