Individual
MS. IMANI JANAE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3444 WISCONSIN AVE, VICKSBURG, MS 39180-5331
(601) 786-8091
Mailing address
3444 WISCONSIN AVE, VICKSBURG, MS 39180-5331
(601) 786-8091
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MS
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
01/07/2025
Last updated
02/07/2025
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