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Individual
MS. KELLY J GREEN
Active
Individual
MS. KELLY J GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.184959
OH
104100000X
Social Worker
Primary
S.2309975
OH
175T00000X
Peer Specialist
0002478
OH
Other
Enumeration date
12/01/2021
Last updated
02/23/2024
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