Greene, Diane M.
Greene, Diane M. is an sole proprietor health care provider with primary practice located at 147 Wallis Rd , Chestnut Hill MA 02467-3112. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Greene, Diane M. can be contacted via phone (617) 522-5553.Contact Information
Primary practice address
147 Wallis Rd
Chestnut Hill MA 02467-3112
Phone: (617) 522-5553
Fax: (508) 349-2911
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 1988 | Massachusetts |
Profile Details
| NPI number | 1093934812 |
|---|---|
| LBN Legal business name | Greene, Diane M. |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 24th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093934812 | NPPES |
| Massachusetts | MEDICAID | 0505196 |
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