Individual
BRENDA DENISE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AC0356 CAA-DC
Contact information
Practice address
425 BRIGHTSEAT RD, LANDOVER, MD 20785-4708
(301) 209-5254
Mailing address
425 BRIGHTSEAT RD, LANDOVER, MD 20785-4708
(301) 209-5254
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC0356
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AC0356
—
MD
Enumeration date
08/05/2021
Last updated
08/05/2021
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