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Individual

JASON THOMAS GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
1401 N MICHAEL WAY, #G133, LAS VEGAS, NV 89108-1491
(702) 287-0218
Mailing address
1401 N MICHAEL WAY, #G133, LAS VEGAS, NV 89108-1491
(702) 287-0218

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NOT VALID
NOT VALID
Enumeration date
07/16/2010
Last updated
10/14/2013
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