Individual
MRS. LORETTA W. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
681 BROUGHTON ST, ORANGEBURG, SC 29115-6621
(803) 290-3155
Mailing address
681 BROUGHTON ST, ORANGEBURG, SC 29115-6621
(803) 290-3155
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4632
SC
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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