Healthcare Provider Details

I. General information

NPI: 1447742895
Provider Name (Legal Business Name): DARREON DARRELL GREER SR. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 W 3RD ST
DAYTON OH
45417-1814
US

IV. Provider business mailing address

6700 WEALTHY LN
DUBLIN OH
43016-7840
US

V. Phone/Fax

Practice location:
  • Phone: 937-640-1679
  • Fax:
Mailing address:
  • Phone: 615-738-8668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP.08229
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: