Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor |
NPI | 1003287194 |
---|---|
Provider Name | La Vondra Green |
First Address | New Orleans, LA 70115-3553 |
Second Address | New Orleans, LA 70115-3553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2015 |
Last Update Date | 20/04/2018 |