MR. DWAYNE GREEN PS-A NPI 1114697679

NPI Information

MR. Dwayne Green, PS-A is a peer specialist in Canton, OH. The provider is 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. MR. Dwayne Green, PS-A NPI is 1114697679. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

STARK COUNTY TASC, INC.
624 MARKET AVE NORTH
CANTON, OH
ZIP 44702-017
Phone: (330) 479-1912

The enumeration date for this NPI number is 9/16/2021 and was last updated on 9/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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