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Individual

TRACEY LOUISE GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
882 OAKMAN BLVD STE D, DETROIT, MI 48238-4019
(313) 961-7990
Mailing address
35870 SHERBORNE DR, CLINTON TOWNSHIP, MI 48035-3565
(586) 224-4595
(586) 204-0681

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704290410
MI

Other

Enumeration date
09/16/2014
Last updated
10/20/2021
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