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Individual

REBECCA ROSE GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PROVISIONAL LICENSED

Contact information

Practice address
722 SO LINCOLN AVE, SUITE 1, YORK, NE 68467
(402) 362-6128
(402) 362-7012
Mailing address
1604 ROAD E, BRADSHAW, NE 68319

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
730
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10025207900
REBECCA GREEN PLADC
01
10025208000
REBECCA GREEN PLADC
01
10025208300
REBECCA GREEN PLADC
01
47052851582
REBECCA GREEN PLADC
Enumeration date
11/13/2006
Last updated
11/03/2008
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