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Individual

CRYSTAL LATASHA GREENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5030 W MOUNTAIN ST APT 18, STONE MOUNTAIN, GA 30083-2845
(678) 334-4914
Mailing address
5030 W MOUNTAIN ST APT 18, STONE MOUNTAIN, GA 30083-2845
(678) 334-4914

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0014183784
GA

Other

Enumeration date
10/18/2021
Last updated
10/18/2021
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