Individual
TATIANA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-2
Contact information
Practice address
6336 99TH ST, REGO PARK, NY 11374-1979
(718) 459-2558
Mailing address
6336 99TH ST, REGO PARK, NY 11374-1979
(718) 459-2558
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29750
NY
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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