Individual
BETTY MILLER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.DIV., M.ED., M.A.,
Contact information
Practice address
220 BAGLEY, SUITE 1100, DETROIT, MI 48226
(313) 961-7990
Mailing address
8749 LILLY DRIVE, YPSILANTI, MI 48197-9651
(313) 961-7990
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301012675
MI
Other
Enumeration date
11/01/2006
Last updated
10/20/2008
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