MEDICARE: DAKOTA A 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
1	106S00000X	Behavior Technician		HI

General Provider Information

NPI Number	:	1265240394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKOTA A GREEN

Provider Business Mailing Address
First Line	:	PO BOX 6250
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-0250
Country	:	US
Telephone Number	:	888-238-1818
Fax Number	:	855-915-1521

Provider Business Practice Location Address
First Line	:	201 N ILLINOIS ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1904
Country	:	US
Telephone Number	:	317-732-8380
Fax Number	:	855-892-0299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2024
Last Update Date	:	03/11/2026

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Directions to “ DAKOTA A GREEN ” Practice Location

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