Individual
MARY J, PHILLIPS GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD,LMHC,LMFT, LCPC
Contact information
Practice address
10324 CANYON RD E, SUITE 208, PUYALLUP, WA 98373-1013
(253) 267-1760
(253) 503-1628
Mailing address
10324 CANYON RD E, SUITE 208, PUYALLUP, WA 98373-1013
(253) 267-1760
(253) 503-1628
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCPC-399
ID
101YM0800X
Mental Health Counselor
LH00009327
WA
106H00000X
Marriage & Family Therapist
LF-00002624
WA
106H00000X
Marriage & Family Therapist
Primary
LMFT-35
ID
Other
Enumeration date
05/23/2007
Last updated
09/18/2012
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