Individual
MRS. KATHERINE MAVIS GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP M.A. CCC
Contact information
Practice address
14234 SHORELINE DR, GRANGER, IN 46530-4849
(248) 953-5126
Mailing address
14234 SHORELINE DR, GRANGER, IN 46530-4849
(248) 953-5126
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IN
Other
Enumeration date
10/24/2020
Last updated
10/24/2020
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