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Individual

EBONI GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
39090 GARFIELD RD, CLINTON TOWNSHIP, MI 48038-4093
(248) 829-0129
Mailing address
39090 GARFIELD RD, CLINTON TOWNSHIP, MI 48038-4093
(248) 829-0129

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801099829
MI

Other

Enumeration date
12/29/2017
Last updated
12/29/2017
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