Individual
SHAWNNETTA N GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAPC
Contact information
Practice address
3464 FAIRBURN RD BLDG 4, DOUGLASVILLE, GA 30135-2926
(678) 379-3055
Mailing address
85 LAKERIDGE DR, TEMPLE, GA 30179-4301
(678) 379-3055
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC008679
GA
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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