Most Relevant Information
Provider Data
| NPI Number: | 1003521725 |
| Provider Name: | SHAWNNETTA N GREEN LAPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | APC008679 |
Most Important Dates
| Enumeration Date: | 01/17/2023 |
| Last Updated: | 01/17/2023 |
Provider Practice Location
3464 FAIRBURN RD BLDG 4
DOUGLASVILLE
GA
301352926
Practice Location Phone/Fax
| Phone: | 6783793055 |
| Fax: |
Provider Mailing Location
85 LAKERIDGE DR
TEMPLE
GA
301794301
Provider Mailing Phone/Fax
| Phone: | 6783793055 |
| Fax: |