Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 415 | NM |
NPI | 1093813826 |
---|---|
Provider Name | Dr. Martin Glenn Greer |
First Address | Las Cruces, NM 88001-5327 |
Second Address | Las Cruces, NM 88001-5327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |