Individual provider · Type 1 NPI

Dominique Green

Professional Counselor · Marietta, GA

NPI number 1053174664 Active

Practice location

50 Whitlock Pl SW
Marietta, GA 30064-3164

Call (404) 369-0816 Map

Mailing address

4370 Satellite Blvd Apt 510
Duluth, GA 30096-4058

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XAPC009183 (GA)

Professional Counselor: Definition to come...

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About NPI 1053174664

Dominique Green's National Provider Identifier is 1053174664, issued on Feb 5, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Marietta, GA. The record was last updated on Feb 5, 2024.