Individual
DONQUAEJA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11067 SOUTHFORK AVE. BUILDING B, BATON ROUGE, LA 70816
(877) 418-2978
Mailing address
723 POINT ST, HOUMA, LA 70360-4744
(985) 851-4488
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
07/21/2023
Last updated
09/26/2023
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