Individual
MRS. MARTHA G GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1105 S COLLEGE RD, STE A, LAFAYETTE, LA 70503
(337) 232-9113
(337) 232-0022
Mailing address
1105 S COLLEGE RD, STE A, LAFAYETTE, LA 70503
(337) 232-9113
(337) 232-0022
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
726
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SCG20
GROUP MEDICARE #
LA
Enumeration date
06/17/2006
Last updated
07/08/2007
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