Provider Demographics
NPI:1639795032
Name:GREENE, ALANA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 E KENTUCKY AVE APT 520
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2012
Mailing Address - Country:US
Mailing Address - Phone:305-803-1363
Mailing Address - Fax:
Practice Address - Street 1:2711 SW 137TH AVE STE 98
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6361
Practice Address - Country:US
Practice Address - Phone:305-803-1363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA18922235Z00000X
COSLP0005408235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist