Individual
TIRRELL GREENE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 480775, CHARLOTTE, NC 28269-5306
(412) 923-8092
Mailing address
PO BOX 480775, CHARLOTTE, NC 28269-5306
(412) 923-8092
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
106S00000X
Behavior Technician
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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