| NPI | 1134481856 |
|---|---|
| Former Name | STEPHENIA GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2014-02-06 |