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Individual
MR. GARY LANE GREEN
Active
Individual
MR. GARY LANE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC, LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
P1205057
AR
106H00000X
Marriage & Family Therapist
Primary
M1205005
AR
Other
Enumeration date
02/21/2009
Last updated
06/26/2012
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