| Doctor Name: | LATASHA RENEA GREEN |
| NPI Number: | 1023283074 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCAS LPC CCS |
| License Number: | 7704 |
| Business Practice Address: | 312 Sterlingworth St Windsor, NC - 279831724 |
| Business Phone Number: | 2527943834 |
| Business Fax Number: | 2527943204 |
| Mailing Address: | 2317 Executive Cir Ste B, GREENVILLE |
| State: | NC |
| Postal Code: | 278343762 |
| Phone Number: | 2525515544 |
| Fax Number: | 2527510661 |
| NPI Enumeration Date: | 04/29/2008 |
| NPI Last Update Date: | 10/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 7704 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |