MIKKISHA SHARAE GREENE

DES MOINES, IA
NPI1396251211
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IA  14117)
Enumeration Date2017-12-15
Last Update Date2017-12-15
Business Address
MIKKISHA SHARAE GREENE
3806 EASTON BLVD
DES MOINES, IA 50317-5730
Phone number: 515-262-0349
Mailing Address
MIKKISHA SHARAE GREENE
3806 EASTON BLVD
DES MOINES, IA 50317-5730
Phone number: 515-262-0349
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