Individual
MRS. INTISSAR ANN GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
930 W SOUTHERN AVE, MESA, AZ 85210-4938
(480) 835-0857
(480) 898-0138
Mailing address
930 W SOUTHERN AVE, MESA, AZ 85210-4938
(480) 835-0857
(480) 898-0138
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP6886
AZ
Other
Enumeration date
08/20/2010
Last updated
08/20/2010
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