Individual
MR. MILES ANTHONY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
701 W WETMORE RD, TUCSON, AZ 85705-1547
(520) 696-5000
Mailing address
7200 E CRYSTAL MIST DR, TUCSON, AZ 85750-6454
(520) 299-0041
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
541533
—
AZ
Enumeration date
03/05/2007
Last updated
07/25/2007
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