Individual
DR. DAWN RENE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7272 WURZBACH RD STE 601, SAN ANTONIO, TX 78240-4803
(210) 615-3483
Mailing address
201 COUNTY ROAD 411, NACOGDOCHES, TX 75961-7629
(936) 645-5120
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
38264
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38264
LICENSE
TX
Enumeration date
01/07/2020
Last updated
01/07/2020
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