Individual
AQUANDA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS, LCMHC
Contact information
Practice address
249 E NC HIGHWAY 54 STE 320, DURHAM, NC 27713-2490
(919) 402-6939
Mailing address
115 WOODTRELLIS CT, DURHAM, NC 27703-9612
(919) 402-6939
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24361
NC
101YM0800X
Mental Health Counselor
17294
NC
Other
Enumeration date
03/07/2019
Last updated
08/21/2024
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