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Individual

DORIS GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1801 6TH AVE, TROY, NY 12180-3440
(518) 274-5143
(518) 273-1350
Mailing address
PO BOX 417153, BOSTON, MA 02241-7153
(518) 952-8140
(518) 952-8287

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1041C0700X
Clinical Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01420800
NY
Enumeration date
03/30/2007
Last updated
07/07/2014
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