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

Latesha Green

Individual provider Developmental Disabilities Clinic/Center · NPI 1972239127

Latesha Green is a Developmental Disabilities Clinic/Center in Charlotte, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

3409 Dominion Green Dr
Charlotte, NC 28269-7932
Phone: (704) 906-4522
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X (NC)
Developmental Disabilities Clinic/Center Taxonomy 261QD1600X (NC)

Record details

NPI number1972239127
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 29, 2022
Last updated in NPPESJuly 29, 2022
Certification dateJuly 29, 2022
Mailing address3409 Dominion Green Dr, Charlotte, NC 28269-7932

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