Individual
MS. RACHEL JACKSON GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
411 E PARK ST STE 106, CHAMPAIGN, IL 61820-3862
(217) 714-7042
Mailing address
411 E PARK ST STE 106, CHAMPAIGN, IL 61820-3862
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.108998
IL
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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