Healthcare Provider Details

I. General information

NPI: 1609424803
Provider Name (Legal Business Name): ARIEL M GREEN RSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2019
Last Update Date: 08/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 FERNWOOD DR STE A
BATON ROUGE LA
70806-3130
US

IV. Provider business mailing address

223 FERNWOOD DR STE A
BATON ROUGE LA
70806-3130
US

V. Phone/Fax

Practice location:
  • Phone: 225-923-3733
  • Fax: 225-923-3735
Mailing address:
  • Phone: 225-923-3733
  • Fax: 225-923-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: