Provider Information for 1336386374
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SARAH GREEN LPC
Sex: Female
NPI: 1336386374
Last Updated: 2015-06-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1336386374 | ||||||||
| Enumeration Date | 2009-01-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 11818 FORT SMITH, AR 72917-1818 United States Phone: 479-452-6650 | Fax:479-452-5847 | ||||||||
| Primary Practice Address | 3111 S 70TH ST FORT SMITH, AR 72903-5017 United States Phone: 479-452-6650 | Fax:479-452-5847 | ||||||||
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