Individual
SADIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 LARKSPUR ST, PONDERAY, ID 83852-5011
(208) 255-3334
Mailing address
514 N SIXTH AVE, SANDPOINT, ID 83864-1525
(304) 209-0700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-35936
ID
Other
Enumeration date
03/17/2016
Last updated
07/27/2016
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