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1740059138
ELIZA LIDIE GREEN
PHILADELPHIA, PA
NPI
1740059138
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: PA PC016375)
Enumeration Date
2023-12-27
Last Update Date
2024-01-11
Business Address
ELIZA LIDIE GREEN
1080 N DELAWARE AVE
PHILADELPHIA, PA 19125-4330
Phone number: 804-887-0643
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Mailing Address
ELIZA LIDIE GREEN
1080 N DELAWARE AVE
PHILADELPHIA, PA 19125-4330
Phone number: 215-496-0707
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