Individual provider · Type 1 NPI

Zandral Kewan Green

Mental Health Counselor · Vicksburg, MS

NPI number 1124643069 Active

Practice location

3442 Wisconsin Ave
Vicksburg, MS 39180-5331

Call (601) 634-0181 Map

Mailing address

4222 Commons Cir
Vicksburg, MS 39180-5858

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1124643069

Zandral Kewan Green's National Provider Identifier is 1124643069, issued on Jun 16, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Vicksburg, MS. The record was last updated on Jun 30, 2020.