Individual
MS. AMY MARIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 I ST, DAVIS, CA 95616-4213
(530) 601-5959
Mailing address
28425 N BLACK CANYON HWY, UNIT 2088, PHOENIX, AZ 85085-7601
(480) 404-0716
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AZ
101Y00000X
Counselor
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XXXXX
UNCERTAIN
CA
Enumeration date
03/01/2014
Last updated
03/01/2014
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