Individual
KIMBERLY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 STODDARD RD, RICHMOND, MI 48062-2505
(810) 392-2167
(810) 392-8103
Mailing address
2011 8TH ST, PORT HURON, MI 48060-6327
(810) 488-2961
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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