Individual
REBECCA ANN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC, ICS
Contact information
Practice address
811 HARDING ST, SUITE 1, WAUPACA, WI 54981-2012
(715) 258-6287
(920) 734-2824
Mailing address
811 HARDING STREET, SUITE 1, WAUPACA, WI 54981-5286
(715) 258-6287
(920) 734-2824
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2037-132
WI
Other
Enumeration date
02/16/2009
Last updated
04/18/2017
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