Individual
NICOLE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 7TH AVE, TROY, NY 12180-3410
(518) 270-2631
(518) 270-2973
Mailing address
1600 7TH AVE, TROY, NY 12180-3410
(518) 270-2631
(518) 270-2973
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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