Individual
DAJA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6701 HIGHWAY 67, BENTON, AR 72015-8909
(501) 315-3344
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/23/2021
Last updated
01/03/2023
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