Individual
LACY DAWN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
87 ELM ST, GAINESVILLE, MO 65655-7131
(417) 679-2775
Mailing address
PO BOX 1359, AVA, MO 65608-1359
(417) 683-1111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2025037160
MO
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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