Individual
AMY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9289 PLANTATION OAKS DR, OLIVE BRANCH, MS 38654-6328
(662) 895-3003
Mailing address
9289 PLANTATION OAKS DR, OLIVE BRANCH, MS 38654-6328
(662) 895-3003
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT1693
MS
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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