Individual
WANDA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
119 BULIFANTS BLVD, SUITE B, WILLIAMSBURG, VA 23188-5709
(757) 564-1650
Mailing address
32 TIMBERLINE DR, HAMPTON, VA 23666-1963
(757) 838-3532
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119002203
VA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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