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Individual

COREY MATTHEW GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PEER SUPPORTER

Contact information

Practice address
1034 HARRISBURG PIKE, COLUMBUS, OH 43223-2525
(614) 276-4840
Mailing address
1034 HARRISBURG PIKE, COLUMBUS, OH 43223-2525
(614) 276-4840

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
180368
OH
175T00000X
Peer Specialist
0002753
OH

Other

Enumeration date
08/20/2021
Last updated
04/21/2022
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