Individual
DEWAYNE C GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
41641 N RIDGE RD STE B, ELYRIA, OH 44035-1264
(440) 324-7406
Mailing address
19333 VAN AKEN BLVD, SHAKER HTS, OH 44122-3579
(216) 513-7223
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
141205
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/08/2018
Last updated
10/07/2025
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