Individual
TRINA SHERRINE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17304 NE 114TH AVE, WALDO, FL 32694-4220
(352) 514-8535
Mailing address
17304 NE 114TH AVE, WALDO, FL 32694-4220
(352) 514-8535
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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