Individual
ANGELA ROSE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
365 MARTIN ST, PHILADELPHIA, PA 19128-4842
(267) 246-1858
Mailing address
365 MARTIN ST, PHILADELPHIA, PA 19128-4842
(267) 246-1858
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006199
PA
Other
Enumeration date
07/31/2017
Last updated
07/21/2022
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