Individual
DR. LEE A. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2650 BAHIA VISTA ST STE 201, SARASOTA, FL 34239-2625
(941) 951-6504
(941) 951-6433
Mailing address
2650 BAHIA VISTA ST STE 201, SARASOTA, FL 34239-2625
(941) 951-6504
(941) 951-6433
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY5323
FL
103TA0700X
Adult Development & Aging Psychologist
PY5323
FL
103TC0700X
Clinical Psychologist
PY5323
FL
103TH0100X
Health Service Psychologist
PY5323
FL
Other
Enumeration date
01/21/2007
Last updated
09/28/2007
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