Most Relevant Information
Provider Data
| NPI Number: | 1003199381 |
| Provider Name: | KRISTINA GREEN M.A., CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 016989-1 |
Most Important Dates
| Enumeration Date: | 09/23/2011 |
| Last Updated: | 09/23/2011 |
Provider Practice Location
25855 DANO RD
THERESA
NY
13691
Practice Location Phone/Fax
| Phone: | 3157782942 |
| Fax: |
Provider Mailing Location
25855 DANO RD
THERESA
NY
136913022
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |