Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Destinee Simone Green, PTA

Individual provider Physical Therapy Assistant · NPI 1457151706

Destinee Simone Green, PTA is a Physical Therapy Assistant in Detroit, Michigan. Licensed in Michigan. Registered with an NPI since 2025.

Licensed in
MI
In the registry since
2025
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

4646 John R St
Detroit, MI 48201-1916
Phone: (313) 576-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 5502008400 (MI)

Record details

NPI number1457151706
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedMarch 17, 2025
Last updated in NPPESMarch 17, 2025
Certification dateMarch 17, 2025

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