Individual
MARILYN KATHERINE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
6308 ARDSLEY SQ APT 201A, VIRGINIA BEACH, VA 23464-3542
(314) 456-6460
Mailing address
6308 ARDSLEY SQ APT 201A, VIRGINIA BEACH, VA 23464-3542
(314) 456-6460
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710103647
VA
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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