Individual
JAKE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA INTERN
Contact information
Practice address
607 NORTH AVE BLDG 15, WAKEFIELD, MA 01880-1322
(781) 395-0457
(781) 395-0198
Mailing address
150 FRANKLIN AVE APT 3, CHELSEA, MA 02150-2020
(413) 531-6036
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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