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Katherine Denice Green
Peer Specialist in Moore, Oklahoma
NPI 1174256739

Katherine Denice Green is a Peer Specialist based in Moore, OK. Katherine Denice Green practices in Moore, OK. The NPI Number for Katherine Denice Green is 1174256739 and holds a License No. (Oklahoma).

The current practice location address for Katherine Denice Green is 12511 S Sooner Road Pl, Moore, OK and can be reached out via phone at 405-794-4647 and via fax at 405-794-8541. You can also correspond with Katherine Denice Green through the mailing address at 12511 S SOONER ROAD PL, MOORE, OK - 73165-8105 (mailing address contact number: 405-794-4647).

Location: 12511 S Sooner Road Pl, Moore, OK, 73165-8105
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174256739
Provider Name
Katherine Denice Green
Credential
Provider Entity Type
Individual
Gender
Female
Address
12511 S Sooner Road Pl, Moore, OK, 73165-8105
Phone Number
405-794-4647
Fax Number
405-794-8541
Provider Enumeration Date
07/01/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
12511 S Sooner Road Pl
City
Moore
State
Oklahoma
Zip
73165-8105
Phone Number
405-794-4647
Fax Number
405-794-8541
person
Provider Business Mailing Address Details
Address
12511 S Sooner Road Pl
City
Moore
State
Oklahoma
Zip
73165-8105
Phone Number
405-794-4647
Fax Number
405-794-8541
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Oklahoma)
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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