Healthcare Provider Details

I. General information

NPI: 1497663181
Provider Name (Legal Business Name): JARIAHA GREEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 S SAINT CLAIR ST
TOLEDO OH
43604-8738
US

IV. Provider business mailing address

122 S SAINT CLAIR ST
TOLEDO OH
43604-8738
US

V. Phone/Fax

Practice location:
  • Phone: 419-213-9497
  • Fax: 419-214-1106
Mailing address:
  • Phone: 419-213-9497
  • Fax: 419-214-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: