Individual
MRS. REBECCA MICHELE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCCSLP
Contact information
Practice address
5302 PLYMOUTH ROAD, BALTIMORE, MD 21214
(443) 257-7448
Mailing address
5302 PLYMOUTH ROAD, BALTIMORE, MD 21214
(443) 257-7448
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
04787
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0970760
—
MD
Enumeration date
02/20/2008
Last updated
04/05/2016
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