Individual
WANDA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3316 CLIFF AVE, RICHMOND, VA 23222-2753
(804) 397-4504
Mailing address
3316 CLIFF AVE, RICHMOND, VA 23222-2753
(804) 397-4504
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
3781
VA
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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