Individual
DESIREE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
257 MARTIN LUTHER KING JR DR, EATONTON, GA 31024-8033
(609) 792-0013
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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