Green, Mary Jane
Green, Mary Jane is an sole proprietor health care provider with primary practice located at 511 E 2Nd St , Heavener OK 74937-3419. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Green, Mary Jane can be contacted via phone (918) 653-7718.Contact Information
Primary practice address
511 E 2Nd St
Heavener OK 74937-3419
Phone: (918) 653-7718
Fax: (918) 653-7279
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X |
Profile Details
| NPI number | 1265628853 |
|---|---|
| LBN Legal business name | Green, Mary Jane |
| Credentials | LPC CANDIDATE |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 18th, 2007 |
| Last updated | Jul 6th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265628853 | NPPES |
| Oklahoma | MEDICAID | 100706960F |
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