Individual
CASSIE M GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1577 CONGRESS ST, PORTLAND, ME 04102-2169
(207) 662-5522
Mailing address
27 HAWTHORNE LN, SOUTH PORTLAND, ME 04106-6935
(207) 590-4171
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
ME
174400000X
Specialist
PSY.0004257
CO
Other
Enumeration date
09/10/2013
Last updated
07/20/2020
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