Individual
JONATHAN ANDREW GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 CHINABERRY DR STE 903, BOSSIER CITY, LA 71111-2455
(318) 459-6795
(318) 626-5429
Mailing address
3317 W 4TH ST APT 16, HATTIESBURG, MS 39401-5860
(601) 964-1696
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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