MEDICARE: ESTHER MARIE GREEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	83275	TX

General Provider Information

NPI Number	:	1548991656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTHER MARIE GREEN

Provider Business Mailing Address
First Line	:	9610 AVIARA GDNS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-5024
Country	:	US
Telephone Number	:	210-508-7252
Fax Number	:

Provider Business Practice Location Address
First Line	:	9610 AVIARA GDNS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-5024
Country	:	US
Telephone Number	:	210-508-7252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2022
Last Update Date	:	06/20/2022

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Directions to “ ESTHER MARIE GREEN ” Practice Location

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