Individual
JESSICA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20033 N 19TH AVE STE 121, PHOENIX, AZ 85027-4251
(602) 875-5616
Mailing address
5541 N 9TH AVE, PHOENIX, AZ 85013-1759
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA12173
AZ
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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