Individual
MRS. MIRIAM E GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., L.C.S.W.
Contact information
Practice address
1330 E CHERRY ST, SPRINGFIELD, MO 65802-3429
(417) 862-1377
Mailing address
1330 E CHERRY ST, SPRINGFIELD, MO 65802-3429
(417) 862-1377
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2005025788
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497463802
—
MO
Enumeration date
07/22/2008
Last updated
07/22/2008
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