Individual
LATRAILLE DENISE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.C.T
Contact information
Practice address
4014 E HENRY AVE, TAMPA, FL 33610-3820
(813) 720-1471
(888) 343-9196
Mailing address
4014 E HENRY AVE, TAMPA, FL 33610-3820
(813) 720-1471
(888) 343-9196
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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