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NPI Code Detail

MEDICARE: CALEN GREEN

MEDICARE: CALEN GREEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1871225227
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALEN GREEN
Provider Business Mailing Address
First Line : 7375 EXECUTIVE PL STE 203
Second Line :
City : LANHAM
State : MD
Zip : 20706-6236
Country : US
Telephone Number : 202-207-0720
Fax Number :
Provider Business Practice Location Address
First Line : 7375 EXECUTIVE PL STE 203
Second Line :
City : LANHAM
State : MD
Zip : 20706-6236
Country : US
Telephone Number : 202-207-0720
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2022
Last Update Date : 06/24/2022

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Directions to “ CALEN GREEN ” Practice Location

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