Individual
TAMYKA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 L ST SE, 304, WASHINGTON, DC 20737
(202) 936-9656
Mailing address
6159 64TH AVE APT 6, RIVERDALE, MD 20737-2913
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
009548027
MD
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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