Green, Mary Alice

Green, Mary Alice is an individual health care provider with primary practice located at 1299 Bedford Dr Suite A, Melbourne FL 32940-1900. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Green, Mary Alice can be contacted via phone (321) 259-1662.

Contact Information

Primary practice address
1299 Bedford Dr Suite A Melbourne FL 32940-1900
Phone: (321) 259-1662
Fax: (321) 259-1223
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH2905 Florida

Profile Details

NPI number 1023165537
LBN Legal business name Green, Mary Alice
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023165537 NPPES
Florida Other 104838 PROVIDER NUMBER

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