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Mr. Dwayne Green, PS-A
Peer Specialist in Canton, Ohio
NPI 1114697679

Dwayne Green is a Peer Specialist based in Canton, OH. Dwayne Green practices in Canton, OH and has the professional credentials of PS-A. The NPI Number for Dwayne Green is 1114697679 and holds a License No. (Ohio).

The current practice location address for Dwayne Green is Stark County Tasc, Inc., Canton, OH and can be reached out via phone at 330-479-1912. You can also correspond with Dwayne Green through the mailing address at STARK COUNTY TASC, INC., CANTON, OH - 44702-1017 (mailing address contact number: 330-479-1912).

Location: Stark County Tasc, Inc., Canton, OH, 44702-1017
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114697679
Provider Name
Dwayne Green
Credential
PS-A
Provider Entity Type
Individual
Gender
Male
Address
Stark County Tasc, Inc., Canton, OH, 44702-1017
Phone Number
330-479-1912
Fax Number
Provider Enumeration Date
09/16/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
Stark County Tasc, Inc.
City
Canton
State
Ohio
Zip
44702-1017
Phone Number
330-479-1912
Fax Number
person
Provider Business Mailing Address Details
Address
Stark County Tasc, Inc.
City
Canton
State
Ohio
Zip
44702-1017
Phone Number
330-479-1912
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Ohio)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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