Individual
MRS. KELLY ROBINSON GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC, LPC, LISAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-1345
AZ
101YP2500X
Professional Counselor
Primary
LPC-11799
AZ
Other
Enumeration date
05/30/2011
Last updated
08/26/2022
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