Individual
MS. JACLYN M. GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMHP-E
Contact information
Practice address
1210 WESTOVER HILLS BLVD, RICHMOND, VA 23225-4434
(804) 922-3894
Mailing address
1210 WESTOVER HILLS BLVD, RICHMOND, VA 23225-4434
(804) 922-3894
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790932911
—
VA
Enumeration date
06/07/2013
Last updated
06/07/2013
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