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General NPI Number Information
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NPI Number | 1245548981
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Entity Type | Individual
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Provider Name | TEDDI L GREENE MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/15/2010
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Last Update Date | 04/08/2017
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Provider Practice Location Address
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Address Line | 1124 W RIVERSIDE AVE SUITE LL2
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City | SPOKANE
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State | WA
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Zip | 99201-1132
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Country | US
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Telephone | 509-994-6232
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Fax | 509-484-2128
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Provider Business Mailing Address
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Address Line | PO BOX 7615
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City | SPOKANE
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State | WA
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Zip | 99207-1132
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Country | US
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Telephone | 509-994-6232
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Fax | 509-484-2128
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW 60291569
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License Number State | WA
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