Provider Information for 1023579521
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TAMMI GREEN LCPC
Sex: Female
NPI: 1023579521
Last Updated: 2023-11-17
Certification Date: 2023-11-15
Certification Date: 2023-11-15
Details
| Name | Value | ||||||||||||
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| NPI | 1023579521 | ||||||||||||
| Enumeration Date | 2019-03-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 295 SPARKMAN RD MCMINNVILLE, TN 37110-7670 United States Phone: 360-270-5835 | Fax: | ||||||||||||
| Primary Practice Address | 2352 MSR EUREKA, MT 59917-9418 United States Phone: 360-270-5835 | Fax: | ||||||||||||
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