Individual
MRS. CHRISTINA MARIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
3403B GARDEN VILLA LN, AUSTIN, TX 78704-6915
(855) 832-6727
(772) 675-9100
Mailing address
7108 SOUTH KANNER HYWY, STUART, FL 34997
(323) 447-3647
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11727053
FL
103K00000X
Behavior Analyst
2257
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11727053
BCBA
FL
Enumeration date
02/27/2018
Last updated
10/19/2020
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