| Dr Cornelia Ellis Green, PHD | |
|
419 Pleasant St, Suite 313, Beloit, WI 53511-6249 | |
| (608) 365-7078 | |
| (608) 365-7464 |
| Full Name | Dr Cornelia Ellis Green |
|---|---|
| Gender | Female |
| Speciality | Psychologist - Counseling |
| Location | 419 Pleasant St, Beloit, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023162468 | NPI | - | NPPES |
| 39027300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 951-057 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Cornelia Ellis Green, PHD 419 Pleasant St, Suite 313, Beloit, WI 53511-6249 Ph: (608) 365-7078 | Dr Cornelia Ellis Green, PHD 419 Pleasant St, Suite 313, Beloit, WI 53511-6249 Ph: (608) 365-7078 |
Savannah Marie Boyd, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1225 Emerson St, Beloit, WI 53511 Phone: 706-968-8879 | |
Keith D Gibson, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1969 W Hart Rd, Beloit, WI 53511 Phone: 608-364-5686 Fax: 608-363-5756 |