Individual
JULIE A GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1760 N WOODLAND AVE, ELIZABETH RICHARDSON CENTER, FAYETTEVILLE, AR 72703-2549
(479) 443-4420
Mailing address
551 BEASLEY DR, CENTERTON, AR 72719-9481
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#2252
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5Y523
BLUE CROSS BLUE SHIELD #
AR
Enumeration date
05/04/2006
Last updated
07/08/2007
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