Organization
LOGAN GREEN, PH.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN GREEN PH.D. (NEUROPSYCHOLOGIST)
(860) 632-1296
Entity
Organization
Contact information
Practice address
494 MAIN ST, APT 1, CROMWELL, CT 06416-2040
(860) 632-1296
Mailing address
494 MAIN ST, APT 1, CROMWELL, CT 06416-2040
(860) 632-1296
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
852
CT
Other
Enumeration date
12/15/2006
Last updated
08/22/2020
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