Individual
BONNIE BRIANNA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
508 E WHITEAKER AVE, COTTAGE GROVE, OR 97424-1648
(541) 767-3823
Mailing address
508 E WHITEAKER AVE, COTTAGE GROVE, OR 97424-1648
(541) 767-3823
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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