Individual
MRS. AYANA T GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
112 BROAD ST, JONESBORO, GA 30236-3563
(404) 317-8215
Mailing address
112 BROAD ST, JONESBORO, GA 30236-3563
(404) 317-8215
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC005885
GA
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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