Individual
GLORIA J GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1613 WINDSOR DR, MESQUITE, TX 75149-6258
(214) 546-4261
Mailing address
PO BOX 850405, MESQUITE, TX 75185-0405
(214) 546-4261
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1315
TX
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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