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Individual

KAILYN O GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
601 1ST AVE N, GREAT FALLS, MT 59401-2510
(406) 454-6973
Mailing address
601 1ST AVE N, GREAT FALLS, MT 59401-2510
(406) 454-6973

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
32900
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32900
STATE LICENSE
MT
Enumeration date
03/28/2019
Last updated
07/29/2021
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