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Dr. Stacy Robin Green, MD
General Practice Physician in Boulder, Colorado
NPI 1558686162

Stacy Robin Green is a General Practice Physician based in Boulder, CO. Stacy Robin Green practices in Boulder, CO and has the professional credentials of MD. The NPI Number for Stacy Robin Green is 1558686162 and holds a License No. (Colorado).

The current practice location address for Stacy Robin Green is 3985 Wonderland Hill Ave Ste 107, Boulder, CO and can be reached out via phone at 303-717-2521.

Location: 3985 Wonderland Hill Ave Ste 107, Boulder, CO, 80304-1038
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558686162
Provider Name
Stacy Robin Green
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
3985 Wonderland Hill Ave Ste 107, Boulder, CO, 80304-1038
Phone Number
303-717-2521
Fax Number
Provider Enumeration Date
04/07/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3985 Wonderland Hill Ave Ste 107
City
Boulder
State
Colorado
Zip
80304-1038
Phone Number
303-717-2521
Fax Number
person
Provider Business Mailing Address Details
Address
3985 Wonderland Hill Ave Ste 107
City
Boulder
State
Colorado
Zip
80304-1038
Phone Number
303-717-2521
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
50364 (Colorado)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
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