Individual
ROBERT ANDREW GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1016 EUCLID AVE, CHARLOTTE, NC 28203-4520
(704) 807-5699
Mailing address
9611 BROOKDALE DR STE 100-122, CHARLOTTE, NC 28215-8719
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11208
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11208
STATE OF NORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY
NC
Enumeration date
10/10/2017
Last updated
10/10/2017
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