Individual
TRACEY ARLETTA GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10743 165TH ST, JAMAICA, NY 11433-2406
(718) 206-1640
Mailing address
10743 165TH ST, JAMAICA, NY 11433-2406
(718) 206-1640
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003510-1
NY
Other
Enumeration date
06/11/2009
Last updated
06/11/2009
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