MRS. Malita Elice Green, B.A.

NPI #1891051330 in Shawnee, Oklahoma

Provider Information

NPI Number: 1891051330
Entity Type: Individual
Name: MRS. Malita Elice Green, B.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: B.A.
Enumeration Date: Apr 10, 2012
Last Updated: Apr 10, 2012

Practice Location

Address: 102 ASHLEY DR
City: Shawnee
State: Oklahoma
ZIP Code: 74804-9710
Phone: (405) 808-5875

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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