Individual
TIMOTHY J GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA CCC/SLP
Contact information
Practice address
6 WOLCOTT ST, WAKEFIELD, MA 01880-1528
(781) 245-5992
Mailing address
6 WOLCOTT ST, WAKEFIELD, MA 01880-1528
(781) 245-5992
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
565
MA
Other
Enumeration date
09/11/2013
Last updated
09/11/2013
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