STACIE DIANE GREEN

PHILADELPHIA, PA
NPI1386972628
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2009-11-25
Last Update Date2009-11-25
Business Address
-- STACIE DIANE GREEN
1315 WINDRIM AVE
PHILADELPHIA, PA 19141-2710
Phone number: 609-502-8609
Mailing Address
-- STACIE DIANE GREEN
42 HARWOOD LN
CLEMENTON, NJ 08021-3606
Phone number: 609-502-8609