Individual
MRS. SUSAN BLAKE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 LINCOLN DR, ABILENE, TX 79601-2023
(325) 676-4030
(325) 676-2016
Mailing address
2500 LINCOLN DR, ABILENE, TX 79601-2023
(325) 676-4030
(325) 676-2016
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
9853
TX
106H00000X
Marriage & Family Therapist
Primary
623
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3648 LC
BLUE CROSS BLUE SHIELD #
TX
Enumeration date
11/17/2006
Last updated
09/11/2025
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