Individual
MRS. SHELLEY JO GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 N CUMMINGS LN, WASHINGTON, IL 61571-9646
(309) 444-1000
(309) 444-7000
Mailing address
1003 N CUMMINGS LN, WASHINGTON, IL 61571-9646
(309) 444-1000
(309) 444-7000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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