Individual
MR. WILLIAM ELLIS GREEN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 NW PLEASANT VIEW RDG, LAWTON, OK 73505-9503
(580) 483-5248
Mailing address
14 NW PLEASANT VIEW RDG, LAWTON, OK 73505-9503
(580) 483-5248
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
03/01/2013
Last updated
03/01/2013
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