SUZANNE E GREEN PHD PA
Psychologist at Nob Hill Rd, Fort Lauderdale, FL

License number
Florida PY5213
Category
Psychologist
Type
Psychologist
Owner
Name: DR. SUZANNE E GREEN PHD, PA
Title: PRESIDENT
Phone: (954) 146-8415
Address
Address
4399 N Nob Hill Rd, Fort Lauderdale, FL 33351
National Provider ID: 1851689418
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SUZANNE E GREEN, PHD, PA

Fort Lauderdale, FL

Industry:
Nonclassifiable Establishments
Doing business as:
Suzanne E Green, PH.D., PA
Registration:
Dec 8, 2010
Addresses:
4399 Nob Hl Rd, Fort Lauderdale, FL 33351 (Physical)
2921 W Abiaca Cir, Fort Lauderdale, FL 33328 (Mailing)
State ID:
P10000099324
Business type:
Florida Profit Corporation
President:
Suzanne E Green (President), 2921 W Abiaca Cir, Fort Lauderdale, FL 33328 (Physical)
Agent:
Suzanne Green,2921 W Abiaca Cir, Fort Lauderdale, FL 33328 (Physical)
EIN:
27-4216023

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