Individual
IMAN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11616 SOUTHFORK AVE, BATON ROUGE, LA 70816
(225) 291-9646
Mailing address
5412 RUE SHAYLYN, BAKER, LA 70714-8022
(770) 906-8614
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/12/2022
Last updated
05/15/2026
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