Green, Jeanetta Faye

Green, Jeanetta Faye is an individual health care provider with primary practice located at 8700 E 29Th St N , Wichita KS 67226-2169. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Green, Jeanetta Faye can be contacted via phone (316) 634-8700.

Contact Information

Primary practice address
8700 E 29Th St N Wichita KS 67226-2169
Phone: (316) 634-8700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1659899516
LBN Legal business name Green, Jeanetta Faye
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2017
Last updated Jul 21st, 2022 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1659899516 NPPES
Kansas MEDICAID 201181820A

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