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NPI Code Detail

MEDICARE: DR. HEATH GREENE PH.D.

MEDICARE: DR. HEATH GREENE PH.D.
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
1103TC0700XClinical Psychologist3057NC

General Provider Information

NPI Number : 1982718045
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEATH GREENE PH.D.
Provider Business Mailing Address
First Line : 8025 N POINT BLVD
Second Line : SUITE 231
City : WINSTON SALEM
State : NC
Zip : 27106-3262
Country : US
Telephone Number : 336-896-0065
Fax Number : 336-896-0710
Provider Business Practice Location Address
First Line : 8025 N POINT BLVD
Second Line : SUITE 231
City : WINSTON SALEM
State : NC
Zip : 27106-3262
Country : US
Telephone Number : 336-896-0065
Fax Number : 336-896-0710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 07/08/2007

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Directions to “ DR. HEATH GREENE PH.D.” Practice Location

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