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NPI Code Detail

MEDICARE: JAKIRIE JASHALL GREEN

MEDICARE: JAKIRIE JASHALL GREEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystLA

General Provider Information

NPI Number : 1154257459
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAKIRIE JASHALL GREEN
Provider Business Mailing Address
First Line : 350 FAIRWAY DR
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number : 877-418-2978
Fax Number : 866-500-2186
Provider Business Practice Location Address
First Line : 4201 N I 10 SERVICE RD W
Second Line :
City : METAIRIE
State : LA
Zip : 70006-6713
Country : US
Telephone Number : 504-475-5303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2026
Last Update Date : 06/23/2026

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Directions to “ JAKIRIE JASHALL GREEN ” Practice Location

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