Individual
MRS. ANTONETTE MARIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2 BRONZE POINTE S STE A, SWANSEA, IL 62226-8307
(618) 207-2547
Mailing address
205 HICKORY RDG, BELLEVILLE, IL 62223-3443
(618) 593-4626
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.017413
IL
Other
Enumeration date
03/15/2023
Last updated
03/15/2023
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