Individual
ELIZABETH GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
524 SIGNAL HILL DRIVE EXT, STATESVILLE, NC 28625-4391
(704) 871-1045
Mailing address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1894
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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