Individual
SUSANNE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 AUTUMN SPRINGS CT STE 1A, FRANKLIN, TN 37067-8274
(615) 614-8833
Mailing address
205 LONDON LN, FRANKLIN, TN 37067-4421
(615) 614-8833
(615) 614-8811
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-57001
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-57001
BACB
TN
Enumeration date
07/27/2018
Last updated
07/27/2018
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