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General NPI Number Information
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NPI Number | 1710498860
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Entity Type | Individual
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Provider Name | ANGELA GREENE
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Gender | Female
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 2850 COLUMBINE RD
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City | DENVER
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State | CO
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Zip | 80221-7600
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Country | US
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Telephone | 303-433-0282
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Fax |
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Provider Business Mailing Address
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Address Line | 497 TUCKER DR
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City | MAYSVILLE
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State | KY
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Zip | 41056-9111
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 142109
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0005499
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License Number State | CO
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