Individual
LYDIA J. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 833-2500
Mailing address
8148 CHEYENNE ST, DETROIT, MI 48228-2788
(313) 404-2351
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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