Individual
LATASHA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST STE 200, FOREST HILLS, NY 11375-4739
(718) 762-7633
Mailing address
1453 E 93RD ST, BROOKLYN, NY 11236-5042
(347) 309-1276
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NY
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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