Individual
BETHANY GRACE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
4640 MARTIN RD, CUMMING, GA 30041-5542
(678) 679-1261
(678) 250-9010
Mailing address
4640 MARTIN RD, CUMMING, GA 30041-5542
(678) 679-1261
(678) 250-9010
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/11/2020
Last updated
11/11/2020
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