Individual
MYA NICOLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
12628 HOOPER RD, BATON ROUGE, LA 70818-3500
(225) 953-8170
Mailing address
38652 RED BUD LN, DENHAM SPRINGS, LA 70706-0479
(901) 277-7262
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
19419
LA
Other
Enumeration date
07/30/2025
Last updated
09/23/2025
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