Individual
MISS AMY JO GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY. S
Contact information
Practice address
7301 N 58TH AVE, GLENDALE, AZ 85301-1893
(757) 287-3524
Mailing address
15740 N 83RD AVE APT 2071, PEORIA, AZ 85382-4803
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133328
—
AZ
Enumeration date
02/13/2007
Last updated
07/26/2007
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