Individual
HARRIETTE DENICE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1055 W HENDERSON AVE, PORTERVILLE, CA 93257-1490
(559) 788-1250
(559) 782-4712
Mailing address
8267 GREENVIEW DR, JONESBORO, GA 30236-4183
(770) 825-2134
(862) 298-0744
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
4301050673
MI
2084P0800X
Psychiatry Physician
051654
GA
2084P0800X
Psychiatry Physician
4301050673
MI
2084P0802X
Addiction Psychiatry Physician
4301050673
MI
2084P0804X
Child & Adolescent Psychiatry Physician
4301050673
MI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
C144317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4732412
—
MI
05
—
4732421
—
MI
05
—
4732430
—
MI
05
—
4732440
—
MI
Enumeration date
06/23/2006
Last updated
01/19/2021
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