Individual
SALLY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 MARYLAND AVE, MCCOMB, MS 39648-3926
(601) 250-4815
Mailing address
3678 WILEY RD, MONTGOMERY, AL 36106-3255
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1987
AL
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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