Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 03445 | MD |
NPI | 1023307444 |
---|---|
Provider Name | Monica Lynne Greene |
First Address | Largo, MD 20774-5327 |
Second Address | Greenbelt, MD 20770-3329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 01/07/2021 |