Individual
SANDRA GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6617 LETOHATCHEE ST, PANAMA CITY, FL 32404-8029
(185) 086-6705
Mailing address
6617 LETOHATCHEE ST, PANAMA CITY, FL 32404-8029
(185) 086-6705
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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