Individual
MRS. LISA MICHELLE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
835 MASON ST STE B220, DEARBORN, MI 48124-2262
(313) 561-9064
Mailing address
13262 CHESTNUT LN, TAYLOR, MI 48180-6347
(734) 732-9635
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401009728
MI
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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