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Individual

JESSICA SHANTE GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1208 E CHURCHVILLE RD STE 300, BEL AIR, MD 21014-3485
(410) 893-4600
Mailing address
950 S GEORGE MASON DR APT 714, ARLINGTON, VA 22204-1864
(706) 329-7050

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
0903003712
VA
104100000X
Social Worker
Primary
30282
MD
104100000X
Social Worker
MSW010482
GA

Other

Enumeration date
06/12/2023
Last updated
06/30/2023
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