Individual
DR. DIANE M. GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
147 WALLIS RD, CHESTNUT HILL, MA 02467-3112
(617) 522-5553
(508) 349-2911
Mailing address
15 PHEASANT RUN, WELLFLEET, MA 02667-7027
(508) 349-0439
(508) 349-2911
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1988
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0505196
—
MA
Enumeration date
04/24/2007
Last updated
07/08/2007
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