Organization
JOHNNY D GREEN MSHR, LPC,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNNY DUANE GREEN MSHR, LPC (OWNER)
(580) 277-5423
Entity
Organization
Contact information
Practice address
597 COLT LN, ARDMORE, OK 73401-9138
(580) 277-5423
(580) 657-2441
Mailing address
PO BOX 1427, ARDMORE, OK 73402-1427
(580) 277-5423
(580) 657-2441
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4694
OK
Other
Enumeration date
03/01/2014
Last updated
03/01/2014
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