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General NPI Number Information
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NPI Number | 1447173745
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Entity Type | Individual
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Provider Name | CARLY M GREEN PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 2121 ALPINE PL APT 304
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City | CINCINNATI
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State | OH
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Zip | 45206-2691
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Country | US
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Telephone | 847-471-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 ALPINE PL APT 304
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City | CINCINNATI
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State | OH
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Zip | 45206-2691
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Country | US
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Telephone | 847-471-0090
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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 | 09004
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License Number State | OH
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