Individual
AMBER BRIANNA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, SPED, RBT, PLBA
Contact information
Practice address
410 TEACO RD, KENNETT, MO 63857-3239
(870) 565-9776
(870) 565-9740
Mailing address
410 TEACO RD, KENNETT, MO 63857-3239
(870) 565-9776
(870) 565-9740
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2025005579
MO
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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