Organization
SUZANNE E GREEN PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZANNE E GREEN PHD, PA (PRESIDENT)
(954) 146-8415
Entity
Organization
Contact information
Practice address
4399 N NOB HILL RD, SUNRISE, FL 33351-5813
(954) 746-8415
(954) 370-5967
Mailing address
2921 W ABIACA CIR, DAVIE, FL 33328-7134
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY5213
FL
Other
Enumeration date
07/18/2011
Last updated
11/29/2011
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