Individual
DR. JOHN NATHANIEL GREENE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6100 N 42ND ST, MILWAUKEE, WI 53209-3560
(414) 449-1546
Mailing address
9484 N FAIRWAY DR, BAYSIDE, WI 53217-1321
(414) 232-0077
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3678-57
WI
103TA0400X
Addiction (Substance Use Disorder) Psychologist
3678-57
WI
103TB0200X
Cognitive & Behavioral Psychologist
3678-57
WI
103TC2200X
Clinical Child & Adolescent Psychologist
3678-57
WI
103TF0200X
Forensic Psychologist
3678-57
WI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
3678-57
WI
103TP2701X
Group Psychotherapy Psychologist
3678-57
WI
Other
Enumeration date
04/27/2019
Last updated
05/09/2019
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