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NPI Code Detail

MEDICARE: ZELLA Y. GREEN

MEDICARE:   ZELLA Y. 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
1104100000XSocial Worker11889LA
2101YM0800XMental Health CounselorLA

General Provider Information

NPI Number : 1821471921
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZELLA Y. GREEN
Provider Business Mailing Address
First Line : 7505 PINES RD STE 1230
Second Line :
City : SHREVEPORT
State : LA
Zip : 71129-3900
Country : US
Telephone Number : 318-562-3707
Fax Number :
Provider Business Practice Location Address
First Line : 7505 PINES RD STE 1230
Second Line :
City : SHREVEPORT
State : LA
Zip : 71129-3900
Country : US
Telephone Number : 318-562-3707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2015
Last Update Date : 12/17/2015

Similar Medicare Providers

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Directions to “ ZELLA Y. GREEN ” Practice Location

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