Individual
KIMBERLY D. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, LMFT
Contact information
Practice address
667 SPRING DRIVE EXT, WINSTON SALEM, NC 27107-9788
(253) 225-5418
(877) 410-5513
Mailing address
667 SPRING DRIVE EXT, WINSTON SALEM, NC 27107-9788
(253) 225-5418
(877) 410-5513
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF00002194
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1091299
—
WA
Enumeration date
11/09/2005
Last updated
07/07/2022
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