Individual
CHRISTIAN CARL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11428 E 20TH ST, TULSA, OK 74128-6451
(918) 878-7877
Mailing address
7402 S VICTOR AVE APT 1612, TULSA, OK 74136-7443
(918) 695-4100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
U082662103
OK
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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