Green, Latesha

Green, Latesha is an sole proprietor health care provider with primary practice located at 3409 Dominion Green Dr , Charlotte NC 28269-7932. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Developmental Disabilities, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is her primary health care specialty. Green, Latesha can be contacted via phone (704) 906-4522.

Contact Information

Primary practice address
3409 Dominion Green Dr Charlotte NC 28269-7932
Phone: (704) 906-4522
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X North Carolina
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X North Carolina

Profile Details

NPI number 1972239127
LBN Legal business name Green, Latesha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2022
Last updated Jul 29th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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