Individual
JACQUELINE A GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW,CHWC
Contact information
Practice address
5727 GASTON AVE APT 101, DALLAS, TX 75214-4665
(972) 571-5847
Mailing address
5727 GASTON AVE APT 101, DALLAS, TX 75214-4665
(972) 571-5847
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
277368
TX
171M00000X
Case Manager/Care Coordinator
—
TX
172V00000X
Community Health Worker
Primary
9166
TX
174H00000X
Health Educator
—
TX
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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