Individual provider · NPI-1
Tirrell Greene III
Day Training/Habilitation Specialist · Charlotte, NC
NPI number1891533907
StatusActive
Last updated in NPPESJul 15, 2024
Details
- NPI
- 1891533907
- Entity type
- Individual (NPI-1)
- Name
- Tirrell Greene III
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 15, 2024
- Certification date
- Jul 15, 2024
- Last updated
- Jul 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | – | Yes |
| 103TP2701X | Psychologist, Group Psychotherapy | – | – | |
| 106S00000X | Behavior Technician | – | – |
Practice location
Po Box 480775Charlotte, NC 28269-5306
Phone 412-923-8092
Mailing address
Po Box 480775Charlotte, NC 28269-5306
Phone 412-923-8092
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