Individual
ANGELIQUE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1585 N 113TH AVE STE 102, AVONDALE, AZ 85392-3938
(623) 259-9819
Mailing address
11791 W BELMONT DR, AVONDALE, AZ 85323-6215
(623) 261-3486
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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