MEDICARE: CLAIRE GREEN MS

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
1	106H00000X	Marriage & Family Therapist	01523	NV

General Provider Information

NPI Number	:	1982096475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE GREEN MS

Provider Business Mailing Address
First Line	:	3838 RAYMERT DR STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3247
Country	:	US
Telephone Number	:	702-720-4669
Fax Number	:

Provider Business Practice Location Address
First Line	:	3838 RAYMERT DR STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3247
Country	:	US
Telephone Number	:	702-720-4669
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2015
Last Update Date	:	04/03/2019

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Directions to “ CLAIRE GREEN MS” Practice Location

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