MATTIE ELYSE GREEN

BENTONVILLE, AR
NPI1629668801
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: AR  Ot-a1462)
Enumeration Date2021-01-21
Last Update Date2021-01-21
Business Address
MATTIE ELYSE GREEN COTA,L
701 N WALTON BLVD
BENTONVILLE, AR 72712-4548
Phone number: 479-250-9838
Mailing Address
MATTIE ELYSE GREEN COTA,L
PO BOX 2764
BENTONVILLE, AR 72712-7704
Phone number:
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