| Doctor Name: | JUDITH GREEN |
| NPI Number: | 1043354772 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 10780 |
| Business Practice Address: | 118 South Sixth St Odessa, DE - 19730 |
| Business Phone Number: | 3023764128 |
| Business Fax Number: | |
| Mailing Address: | 118 South Sixth St, ODESSA |
| State: | DE |
| Postal Code: | 19730 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 10780 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |