Individual
ALICIA ANTOINETTE GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
956 GRAHAM CAMPBELL LN, STATHAM, GA 30666-1896
(404) 723-0715
Mailing address
956 GRAHAM CAMPBELL LN, STATHAM, GA 30666-1896
(404) 723-0715
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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