Individual
JESSICA M GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 ROBB ST, SUMMIT, MS 39666-7053
(601) 276-3040
(601) 249-4234
Mailing address
PO BOX 768, MCCOMB, MS 39649-0768
(601) 684-2173
(601) 249-4234
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PH1965
MS
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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