Individual
KAELYN ELIZABETH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA OTR/L
Contact information
Practice address
9 EL BALAZO, RANCHO SANTA MARGARITA, CA 92688-4114
(949) 378-7823
Mailing address
9 EL BALAZO, RANCHO SANTA MARGARITA, CA 92688-4114
(949) 378-7823
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21809
CA
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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