Individual
ASHLEY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
25 PINE FOREST LN, HAINES CITY, FL 33844-9675
(386) 547-9516
Mailing address
25 PINE FOREST LN, HAINES CITY, FL 33844-9675
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11499
FL
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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