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General NPI Number Information
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NPI Number | 1093203242
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Entity Type | Individual
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Provider Name | HILARY ANN GREENE LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 501 4TH ST S STE 201
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City | PRINCETON
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State | MN
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Zip | 55371-4754
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Country | US
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Telephone | 763-309-1005
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Fax | 763-374-2000
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Provider Business Mailing Address
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Address Line | 18584 TROTT BROOK PKWY NW
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City | ELK RIVER
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State | MN
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Zip | 55330-4662
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Country | US
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Telephone | 763-213-3763
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3548
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License Number State | MN
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