Individual
TALIYAH LAVALE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 SPRINGHALL DR STE A, GOOSE CREEK, SC 29445-5372
(843) 303-7554
Mailing address
8725 HAYDEN GLENN DR, CHARLESTON, SC 29406-9813
(843) 303-7554
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6750
SC
Other
Enumeration date
02/07/2026
Last updated
02/07/2026
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