Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003435645 |
---|---|
Provider Name | Margaret Pohlman Green |
First Address | Memphis, TN 38117-2808 |
Second Address | Memphis, TN 38103-2816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2020 |
Last Update Date | 14/04/2020 |