Individual
SUSAN TATE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 E MAIN ST, KLAMATH FALLS, OR 97601-3236
(541) 883-4754
(541) 883-4775
Mailing address
513 MAIN ST STE 101, KLAMATH FALLS, OR 97601-6057
(901) 497-8665
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1614
TN
235Z00000X
Speech-Language Pathologist
16820
OR
Other
Enumeration date
10/02/2006
Last updated
06/03/2024
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