Provider Demographics
NPI:1225268998
Name:GREENE, STEPHANIE LYNN
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:GREENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 S SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-2921
Mailing Address - Country:US
Mailing Address - Phone:937-383-4441
Mailing Address - Fax:937-383-2348
Practice Address - Street 1:953 S SOUTH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2921
Practice Address - Country:US
Practice Address - Phone:937-383-4441
Practice Address - Fax:937-383-2348
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor