Individual
BECQUELYN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104 ELGIN PL, CLINTON, MS 39056-3946
(601) 966-3238
Mailing address
104 ELGIN PL, CLINTON, MS 39056-3946
(601) 966-3238
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
11/07/2014
Last updated
11/07/2014
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