Individual
TKEYAH KRYSTAL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 N 15TH ST APT 905, PHILADELPHIA, PA 19121-3488
(215) 278-3039
Mailing address
1601 N 15TH ST APT 905, PHILADELPHIA, PA 19121-3488
(215) 278-3039
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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