Individual provider · Type 1 NPI

Eliza Lidie Green

Mental Health Counselor · Philadelphia, PA

NPI number 1740059138 Active

Practice location

1080 N Delaware Ave
Philadelphia, PA 19125-4330

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XPC016375 (PA)

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About NPI 1740059138

Eliza Lidie Green's National Provider Identifier is 1740059138, issued on Dec 27, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Philadelphia, PA. The record was last updated on Jan 11, 2024.