Individual
CARLA JAY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
665 W 4TH ST, WINSTON SALEM, NC 27101-2701
(336) 725-8389
(336) 725-6628
Mailing address
1730 FRANCISCAN TER APT H, WINSTON SALEM, NC 27127-7708
(240) 550-6452
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26024
NC
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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