Individual
NATALIE M GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5440
(573) 632-5990
Mailing address
1725 BUNKER HILL RD, JEFFERSON CITY, MO 65109-5621
(573) 636-7660
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005240
MO
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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