Healthcare Provider Details

I. General information

NPI: 1093813826
Provider Name (Legal Business Name): MARTIN GLENN GREER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 S DON ROSER DR STE A
LAS CRUCES NM
88011-4596
US

IV. Provider business mailing address

1505 S DON ROSER DR STE A
LAS CRUCES NM
88011-4596
US

V. Phone/Fax

Practice location:
  • Phone: 575-680-0682
  • Fax: 575-222-2384
Mailing address:
  • Phone: 575-680-0682
  • Fax: 575-222-2384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number415
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: