Individual
MICHELLE ELLEN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 W CLINTON AVE BLDG B #134, FRESNO, CA 93705-4206
(559) 293-5441
Mailing address
2550 W CLINTON AVE BLDG B #134, FRESNO, CA 93705-4206
(559) 293-5441
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103K00000X
Behavior Analyst
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-EPOTRN
CA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
07/06/2011
Last updated
01/17/2024
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