Individual
LISA M GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1600 SW ARCHER RD, BOX 100166, GAINESVILLE, FL 32610-3003
(352) 265-0301
Mailing address
PO BOX 918025, ORLANDO, FL 32891-0001
(352) 265-0301
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY7657
FL
Other
Enumeration date
06/20/2012
Last updated
08/15/2012
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