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Individual

DEIRDRE GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
24865 US HIGHWAY 23 S STE A, CIRCLEVILLE, OH 43113-9189
(281) 888-8704
Mailing address
24865 US HIGHWAY 23 S STE A, CIRCLEVILLE, OH 43113-9189
(281) 888-8704

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
OH
101YM0800X
Mental Health Counselor
OH
164W00000X
Licensed Practical Nurse
Primary
LPN.105839.MEDS
OH

Other

Enumeration date
06/06/2023
Last updated
12/18/2023
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