Individual
MS. STACY KATRINA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
160010197
Contact information
Practice address
900 CHURCH ST, D2, LAURENS, SC 29360-1668
(864) 387-7998
Mailing address
900 CHURCH ST, D2, LAURENS, SC 29360-1668
(864) 387-7998
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1314015
SC
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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