Individual
MR. JD GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
963 N 1025 E, OGDEN, UT 84404-3832
(801) 499-0758
Mailing address
963 N 1025 E, OGDEN, UT 84404-3832
(801) 499-0758
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4944924-3501
UT
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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