Provider Demographics
NPI:1538228143
Name:GREENWOOD, LAUREN (MA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 HOLCOMB AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1802
Mailing Address - Country:US
Mailing Address - Phone:775-324-5506
Mailing Address - Fax:775-786-5062
Practice Address - Street 1:506 HOLCOMB AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1802
Practice Address - Country:US
Practice Address - Phone:775-324-5506
Practice Address - Fax:775-786-5062
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0778103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist