Provider Demographics
NPI:1841033362
Name:GREEN, HOPE (LMT)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 S. LIMEKILN PIKE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025
Mailing Address - Country:US
Mailing Address - Phone:215-646-6400
Mailing Address - Fax:215-646-0650
Practice Address - Street 1:1825 S. LIMEKILN PIKE
Practice Address - Street 2:SUITE 5
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025
Practice Address - Country:US
Practice Address - Phone:215-646-6400
Practice Address - Fax:215-646-0650
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG010431225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist