Individual
JENNIFER GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBS
Contact information
Practice address
21 VALENCIA CT, JACKSON, MS 39204-4725
(769) 226-6232
Mailing address
PO BOX 59053, JACKSON, MS 39284-9053
(769) 226-6232
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/20/2020
Last updated
01/20/2020
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