Individual
JAMILA ANTOINETTE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3814 12TH ST NE, WASHINGTON, DC 20017-2630
(202) 545-0515
Mailing address
3814 12TH ST NE, WASHINGTON, DC 20017-2630
(202) 545-0515
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106S00000X
—
DC
Enumeration date
04/11/2018
Last updated
06/16/2018
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