| Doctor Name: | ALEXANDRA GREEN |
| NPI Number: | 1780936187 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LCPC, CRC |
| License Number: | 00110929 |
| Business Practice Address: | 129 10th St Carmi, IL - 628211309 |
| Business Phone Number: | 7132039061 |
| Business Fax Number: | |
| Mailing Address: | 129 10th St, CARMI |
| State: | IL |
| Postal Code: | 628211309 |
| Phone Number: | 7132039061 |
| Fax Number: | |
| NPI Enumeration Date: | 10/09/2012 |
| NPI Last Update Date: | 05/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 00110929 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |