Individual
LYDIA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
2250 S FM 2869 STE 5, HOLLY LAKE RANCH, TX 75765-4974
(903) 569-4286
Mailing address
621 N FM 312, WINNSBORO, TX 75494-7628
(903) 569-4286
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT134768
TX
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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