Individual
MISS MALEE' GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 819-4000
(804) 819-5221
Mailing address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 819-4000
(804) 819-5221
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904010838
VA
Other
Enumeration date
01/07/2019
Last updated
08/22/2019
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