| NPI | 1366182842 |
|---|---|
| Former Name | TERRI LYNATTA GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-25630) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |