Organization
KELLY K GREENE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY K GREENE PSY D (PRESIDENT)
(231) 929-9040
Entity
Organization
Contact information
Practice address
921 W 11TH ST STE 1W, TRAVERSE CITY, MI 49684-3002
(231) 929-9040
(231) 929-5586
Mailing address
PO BOX 1024, CADILLAC, MI 49601-6024
(231) 775-6076
(231) 775-0027
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Enumeration date
02/17/2007
Last updated
08/22/2020
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