Individual
STACY LYNN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 GLENBURN AVE, CAMBRIDGE, MD 21613-1414
(410) 221-1400
Mailing address
5278 WHITE DEER RD, DELMAR, DE 19940-3075
(302) 907-0199
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02129
MD
224Z00000X
Occupational Therapy Assistant
U2-0001489
DE
Other
Enumeration date
07/04/2014
Last updated
07/04/2014
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