Individual
MS. KIMBERLY M GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSC-AD, RAC
Contact information
Practice address
4404 QUEENSBURY RD STE 105, RIVERDALE, MD 20737-1074
(301) 864-0919
Mailing address
4404 QUEENSBURY RD STE 105, RIVERDALE, MD 20737-1074
(301) 864-0919
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ADD14102
DC
251S00000X
Community/Behavioral Health Agency
Primary
210310714
MD
Other
Enumeration date
10/31/2007
Last updated
08/25/2021
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