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NPI Code Detail

MEDICARE: MRS. ELIZABETH MARIE GREENE

MEDICARE: MRS. ELIZABETH MARIE GREENE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1321TN

General Provider Information

NPI Number : 1275272007
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH MARIE GREENE
Provider Business Mailing Address
First Line : 177 MOUSE CREEK RD NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3838
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 177 MOUSE CREEK RD NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3838
Country : US
Telephone Number : 888-963-2228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2022
Last Update Date : 06/06/2024

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Directions to “ MRS. ELIZABETH MARIE GREENE ” Practice Location

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