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General NPI Number Information
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NPI Number | 1295224152
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Entity Type | Individual
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Provider Name | KAYLIE GREEN PHD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 4245 MONROE ST APT D
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City | BOZEMAN
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State | MT
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Zip | 59718-1964
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Country | US
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Telephone | 425-422-9362
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Fax |
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Provider Business Mailing Address
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Address Line | 4245 MONROE ST APT D
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City | BOZEMAN
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State | MT
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Zip | 59718-1964
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Country | US
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Telephone | 425-422-9362
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6330
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5071
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License Number State | MT
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