Doctor Name: | CARMANEILA L. GREEN |
NPI Number: | 1396001756 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 000738 |
Business Practice Address: | 67 S Dixie Hwy St Augustine, FL - 320840317 |
Business Phone Number: | 9044297573 |
Business Fax Number: | 9045472731 |
Mailing Address: | Po Box 9113, FLEMING ISLAND |
State: | FL |
Postal Code: | 320060023 |
Phone Number: | 9042159273 |
Fax Number: | 9042644154 |
NPI Enumeration Date: | 04/10/2012 |
NPI Last Update Date: | 09/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 000738 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |