Green, Rebecca

Green, Rebecca is an individual health care provider with primary practice located at 2424 32Nd Ave S Ste 202, Grand Forks ND 58201-6545. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Green, Rebecca can be contacted via phone (701) 746-6336.

Contact Information

Primary practice address
2424 32Nd Ave S Ste 202 Grand Forks ND 58201-6545
Phone: (701) 746-6336
Fax: (701) 772-1030
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 270 North Dakota

Profile Details

NPI number 1508951856
LBN Legal business name Green, Rebecca
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jan 23rd, 2017 - about 8 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 1508951856 NPPES
North Dakota MEDICAID 18288
North Dakota Other 24743
North Dakota MEDICAID 1451969
North Dakota Other 309K9GR
North Dakota Other 61-66614
North Dakota Other 498806

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