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1295136729
TRACEY LOUISE GREEN
DETROIT, MI
NPI
1295136729
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MI 4704290410)
Enumeration Date
2014-09-16
Last Update Date
2021-10-20
Business Address
TRACEY LOUISE GREEN PMHNP
882 OAKMAN BLVD STE D
DETROIT, MI 48238-4019
Phone number: 313-961-7990
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Mailing Address
TRACEY LOUISE GREEN PMHNP
35870 SHERBORNE DR
CLINTON TOWNSHIP, MI 48035-3565
Phone number: 586-224-4595
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