Individual
TANIKA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 LIBERTY PL, SICKLERVILLE, NJ 08081-5705
(856) 861-5448
Mailing address
1600 LIBERTY PL, SICKLERVILLE, NJ 08081-5705
(856) 861-5448
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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