Individual
TAMMY LEE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 OFFSHORE DR, LAKE HAVASU CITY, AZ 86406-6305
(509) 940-7427
Mailing address
3535 OFFSHORE DR, LAKE HAVASU CITY, AZ 86406-6305
(509) 940-7427
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HM60639608
WA
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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