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Individual

MR. CHARLES BARRYMORE GREENE II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCADC

Contact information

Practice address
413 S BROADWAY, CAMDEN, NJ 08103-1211
(856) 757-9190
(856) 338-1892
Mailing address
106 COUNTRY LN, SICKLERVILLE, NJ 08081-9312
(856) 701-4731
(856) 757-0541

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00141700
NJ

Other

Enumeration date
02/22/2008
Last updated
02/22/2008
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