Individual
TACHANDA MONTES GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 N COUTENAY PKWY, MERRITT ISLAND, FL 32953
(321) 455-5100
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(321) 455-5100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
12085
FL
224Z00000X
Occupational Therapy Assistant
Primary
OTA12085
FL
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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