Individual
MAURISSA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, BA, PEL
Contact information
Practice address
900 RIDGE RD STE 1S, HOMEWOOD, IL 60430-1934
(708) 637-1672
Mailing address
11 OAK LN, PARK FOREST, IL 60466-2030
(312) 918-4610
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
2422001
IL
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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