| Doctor Name: | MS. SHANNON GREEN |
| NPI Number: | 1164573275 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD CDE CSR LDN |
| License Number: | DI100000367 |
| Business Practice Address: | 1011 Ingleside Ave Catonsville, MD - 212281318 |
| Business Phone Number: | 4108776077 |
| Business Fax Number: | 4108776087 |
| Mailing Address: | 51 Horseman Ct, RANDALLSTOWN |
| State: | MD |
| Postal Code: | 211334065 |
| Phone Number: | 4108776077 |
| Fax Number: | 4108776087 |
| NPI Enumeration Date: | 01/15/2007 |
| NPI Last Update Date: | 02/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | DI100000367 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DC |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |