Individual
DR. SHANNON M. GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LMFT
Contact information
Practice address
2306 LAKE AUSTIN BLVD, AUSTIN, TX 78703-4546
(512) 775-1908
Mailing address
PO BOX 93042, AUSTIN, TX 78709-3042
(512) 775-1908
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT4900
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00364B
BCBS OF TX
TX
Enumeration date
08/06/2007
Last updated
10/14/2008
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