Individual
DR. JONATHAN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
150 S HUNTINGTON AVE, 116B-4, BOSTON, MA 02130-4817
(857) 364-4763
Mailing address
150 S HUNTINGTON AVE, 116B-4, BOSTON, MA 02130-4817
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
10329
MA
103TC0700X
Clinical Psychologist
PS01503
RI
Other
Enumeration date
08/06/2014
Last updated
04/11/2017
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