Individual
AMANDA LEANN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MOURNING DOVE RD, BLUEFIELD, WV 24701-4885
(304) 809-7617
Mailing address
111 MOURNING DOVE RD, BLUEFIELD, WV 24701-4885
(304) 809-7617
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
F757908
WV
Other
Enumeration date
03/20/2026
Last updated
03/20/2026
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