Individual
WILLIAM M GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
401 1 2 SHERMAN, SUITE 206, COEUR D ALENE, ID 83814-2777
(208) 765-1894
(208) 666-1598
Mailing address
PO BOX 1209, COEUR D ALENE, ID 83816-1209
(208) 765-1894
(208) 666-1598
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY14247
CA
103T00000X
Psychologist
Primary
PSY310
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050444
—
ID
Enumeration date
01/03/2007
Last updated
07/08/2007
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