Individual
SUSAN GAIL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
111 TOWN HOLLOW RD, CEDAR BLUFF, VA 24609-9622
(276) 963-3554
Mailing address
4192 ROCK RIVER RD, ROCK, WV 24747-9739
(304) 589-3761
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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