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General NPI Number Information
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NPI Number | 1790551562
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Entity Type | Individual
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Provider Name | MIRANDA KAE GREENE LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/01/2023
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 32 W STATE ST
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City | BINGHAMTON
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State | NY
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Zip | 13901-2359
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Country | US
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Telephone | 607-296-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 16 OAK HILL RD
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City | BARTON
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State | NY
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Zip | 13734-2319
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Country | US
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Telephone | 607-271-0709
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 122035
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License Number State | NY
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