Green, Jacqualyn F.

Green, Jacqualyn F. is an sole proprietor health care provider with primary practice located at 4755 Kingsway Dr Ste 308 , Indianapolis IN 46205-1571. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Green, Jacqualyn F. can be contacted via phone (317) 257-6773.

Contact Information

Primary practice address
4755 Kingsway Dr Ste 308 Indianapolis IN 46205-1571
Phone: (317) 257-6773
Fax: (317) 863-1414
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 34000712A Indiana
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 35000324A Indiana

Profile Details

NPI number 1093861932
LBN Legal business name Green, Jacqualyn F.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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