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Individual

MS. REBECCA J GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3360 HIGHWAY 411 N, ENGLEWOOD, TN 37329-5276
(423) 887-5131
(423) 887-5917
Mailing address
6350 W ANDREW JOHNSON HWY, DEPARTMENT 100, TALBOTT, TN 37877-8605
(800) 355-3565
(423) 714-2355

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3397
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3711666
MEDICARE ID
TN
Enumeration date
05/27/2006
Last updated
07/26/2013
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