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General NPI Number Information
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NPI Number | 1780375683
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Entity Type | Organization
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Legal Business Name | LAURA M GREENE LICENSED BEHAVIOR ANALYST, PLLC
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 5 CLAY CT
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City | RHINEBECK
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State | NY
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Zip | 12572-2500
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Country | US
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Telephone | 516-395-0806
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Fax |
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Provider Business Mailing Address
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Address Line | 5 CLAY CT
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City | RHINEBECK
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State | NY
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Zip | 12572-2500
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Country | US
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Telephone | 845-204-8738
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. LAURA MICHELLE GREENE
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Credential | LMSW, LBA
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Telephone | 516-395-0806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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