Individual
MRS. RENAE DINA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
8722 119TH STREET CT E, PUYALLUP, WA 98373-7974
(253) 445-2513
Mailing address
8722 119TH STREET CT E, PUYALLUP, WA 98373-7974
(253) 445-2513
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60184900
WA
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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