Individual
MR. DAVID SILAS GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1016 VAUCLUSE ROAD, AIKEN, SC 29801
(803) 642-1085
Mailing address
105 ILEX LANE, AIKEN, SC 29803-8828
(803) 644-1532
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WP8977
—
SC
Enumeration date
04/19/2007
Last updated
07/08/2007
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