Provider Demographics
NPI:1679160592
Name:GREESON, CHRISTOPHER M
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:M
Last Name:GREESON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7579 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1233
Mailing Address - Country:US
Mailing Address - Phone:561-818-0015
Mailing Address - Fax:
Practice Address - Street 1:850 NW FEDERAL HWY STE 173
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-1019
Practice Address - Country:US
Practice Address - Phone:786-206-6500
Practice Address - Fax:866-500-2186
Is Sole Proprietor?:No
Enumeration Date:2020-12-26
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician