MR. Charles Mcclure Green, LICENS PSYCHOLOGIST

NPI #1245225952 in Quiet Dell, West Virginia

Provider Information

NPI Number: 1245225952
Entity Type: Individual
Name: MR. Charles Mcclure Green, LICENS PSYCHOLOGIST
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Psychologist
Credential: LICENS PSYCHOLOGIST
Enumeration Date: Sep 19, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: RT 20
City: Quiet Dell
State: West Virginia
ZIP Code: 26408
Phone: (304) 622-6404

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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