Individual
REGINA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 410-6854
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 410-6854
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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