KATHRYN MARIA GREEN SUDP
NPI 1245092139
Counselor - Addiction (Substance Use Disorder) in Tacoma, WA
Active since January 25, 2024
About Kathryn Maria Green Sudp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHRYN MARIA GREEN SUDP (NPI 1245092139) is an individual addiction (substance use disorder) provider in Tacoma, Washington, licensed in Washington (CP00002975) and active in the NPI registry since January 2024.
NPPES Registry Identity
NPI1245092139
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKATHRYN MARIA GREENCredential: SUDP
Location Address12606 A ST S APT A2Tacoma, WA 98444-5021
Mailing Address12606 A St S Apt A2Tacoma, WA 98444-5021 · (509) 954-5748
Phone(509) 954-5748
Sole ProprietorYes
Enumeration DateJanuary 25, 2024
NPPES CertifiedJanuary 25, 2024
✔ NPI 1245092139 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WA · CP00002975
12606 A ST S APT A2, Tacoma, WA 98444
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245092139, enumerated as an "individual" on January 25, 2024.
The provider is located at 12606 A ST S APT A2 TACOMA, WA 98444 and the phone number is (509) 954-5748.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
