Individual
MICHELLE M GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13709 APOLLO WAY, ROSEMOUNT, MN 55068-2171
(612) 743-5590
Mailing address
13709 APOLLO WAY, ROSEMOUNT, MN 55068-2171
(612) 743-5590
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
1099384
MN
311ZA0620X
Adult Care Home Facility
Primary
1099384
MN
Other
Enumeration date
07/25/2019
Last updated
07/25/2019
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