| Doctor Name: | SUSAN GAIL GREEN |
| NPI Number: | 1831311265 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 111 Town Hollow Rd Cedar Bluff, VA - 246099622 |
| Business Phone Number: | 2769633554 |
| Business Fax Number: | |
| Mailing Address: | 4192 Rock River Rd, ROCK |
| State: | WV |
| Postal Code: | 247479739 |
| Phone Number: | 3045893761 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |