Individual
JESSIC MIRIAM GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
400 SUNRISE HWY, AMITYVILLE, NY 11701-2508
(631) 608-5547
Mailing address
400 SUNRISE HWY, AMITYVILLE, NY 11701-2508
(631) 608-5547
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
57786
—
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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