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General NPI Number Information
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NPI Number | 1295542496
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Entity Type | Individual
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Provider Name | ELIZABETH NOEL GREEN LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 1435 HAW CREEK CIR STE 403
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City | CUMMING
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State | GA
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Zip | 30041-6567
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Country | US
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Telephone | 770-940-9679
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Fax |
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Provider Business Mailing Address
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Address Line | 3823 RIDGE RD
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City | BUFORD
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State | GA
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Zip | 30519-3709
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Country | US
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Telephone | 865-803-7692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW012037
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License Number State | GA
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