Organization
CHATTAHOOCHEE CHILD PSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTEN W GREEN PHD (OWNER/PSYCHOLOGIST)
(678) 971-5355
Entity
Organization
Contact information
Practice address
430 PRIOR STREET NE, GAINESVILLE, GA 30501
(678) 971-5355
(678) 971-5359
Mailing address
430 PRIOR STREET NE, GAINESVILLE, GA 30501
(678) 971-5355
(678) 971-5359
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3114
GA
Other
Enumeration date
02/02/2010
Last updated
08/28/2012
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