PHYLLIS LOUISE GREEN

STOCKTON, CA
NPI1790909695
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-04-12
Last Update Date2007-07-08
Business Address
-- PHYLLIS LOUISE GREEN
8026 LORRAINE AVE SUITE 201
STOCKTON, CA 95210-4224
Phone number: 209-644-6328
Mailing Address
-- PHYLLIS LOUISE GREEN
4230 GISELLE LN
STOCKTON, CA 95206-6509
Phone number: 209-513-0247