Individual
MS. AUTUMN SHAREE GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
507 RITTENHOUSE SQ, MECHANICSBURG, PA 17050-1850
(717) 364-8735
Mailing address
507 RITTENHOUSE SQ, MECHANICSBURG, PA 17050-1850
(717) 364-8735
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL009354
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12147245
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
01
—
SL009354
STATE BOARD OF SPEECH-LANGUAGE AND HEARING EXAMINERS
PA
Enumeration date
09/04/2008
Last updated
10/03/2008
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