# DR. KEVIN M GREEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1649605965
- **Gender:** Man
- **Credential:** PHD, MS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 50020653902 | UT | Yes |
| 106H00000X | Marriage & Family Therapist | LMFT-6350 | ID | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |

## Other

- **Enumeration date:** 09/05/2013
- **Last updated:** 11/12/2024