Doctor Name: | RALPH E GREENE |
NPI Number: | 1164457529 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 1332 |
Business Practice Address: | 505 2nd St Vanceburg, KY - 411791008 |
Business Phone Number: | 6067963021 |
Business Fax Number: | 6067969881 |
Mailing Address: | 611 Forest Ave, MAYSVILLE |
State: | KY |
Postal Code: | 410561411 |
Phone Number: | 6065644016 |
Fax Number: | 6065648288 |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1332 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |