Healthcare Provider Details
I. General information
NPI: 1548543507
Provider Name (Legal Business Name): AMBER ROBINSON GREEN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/26/2011
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 ARCH PL
GREENFIELD MA
01301-2457
US
IV. Provider business mailing address
1 ARCH PL
GREENFIELD MA
01301-2457
US
V. Phone/Fax
- Phone: 413-774-1000
- Fax: 413-774-1776
- Phone: 413-774-1000
- Fax: 413-774-1776
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 9421 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: