Individual
THANE R GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
742 JAMES ST, SYRACUSE, NY 13203-2017
(315) 703-2800
Mailing address
PO BOX 866, SKANEATELES, NY 13152-0866
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NY
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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