Individual
STACY GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1664 BROADWAY, EL CAJON, CA 92021-5201
(619) 579-8685
Mailing address
1664 BROADWAY, EL CAJON, CA 92021-5201
(619) 579-8685
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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