Individual
MS. KELLY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
3559 STANFORD PL, DAYTON, OH 45406-3641
(937) 723-8475
Mailing address
1200 N BROADWAY ST, DAYTON, OH 45402-6112
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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