Individual
BRAIDEN NICOLE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9212 N KELLEY AVE, OKLAHOMA CITY, OK 73131-2419
(405) 242-5070
Mailing address
1605 N HARRISON ST, SHAWNEE, OK 74804-4022
(405) 765-6188
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/14/2015
Last updated
01/24/2019
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