Provider Demographics
NPI:1851687941
Name:GREENE, AMALIA (MSW)
Entity Type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 915
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-0915
Mailing Address - Country:US
Mailing Address - Phone:541-714-3667
Mailing Address - Fax:541-393-2095
Practice Address - Street 1:2403 NW HIGHWAY 101
Practice Address - Street 2:STE H
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-4108
Practice Address - Country:US
Practice Address - Phone:541-714-3667
Practice Address - Fax:541-393-2095
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker