Individual
MARJORIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11600 ELDRIDGE AVE, LAKE VIEW TERRACE, CA 91342-6506
(818) 868-3000
Mailing address
11600 ELDRIDGE AVE, LAKE VIEW TERRACE, CA 91342-6506
(805) 558-7209
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
15044
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2022
Last updated
11/22/2023
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