Individual
DEIRDRE DEA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2727 MARSHALL CT, MADISON, WI 53705-2255
(608) 238-9354
Mailing address
907 ENTERPRISE DR, VERONA, WI 53593-1921
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6887
WI
Other
Enumeration date
03/29/2020
Last updated
03/29/2020
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