Individual
MR. DOUGLAS GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
8715 PLANTATION LN, STE 301 A, MANASSAS, VA 20110-8323
(571) 232-6506
(703) 649-6471
Mailing address
153 REDMON LN, FRONT ROYAL, VA 22630-4957
(571) 208-2056
(703) 649-6471
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701005090
VA
Other
Enumeration date
08/08/2011
Last updated
10/04/2013
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