Green, Tia Jaelaine
Green, Tia Jaelaine is an sole proprietor health care provider with primary practice located at 407 W 15Th St Ste 7 , Edmond OK 73013-3668. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Green, Tia Jaelaine can be contacted via phone (405) 204-4677.Contact Information
Primary practice address
407 W 15Th St Ste 7
Edmond OK 73013-3668
Phone: (405) 204-4677
Fax: (405) 604-0923
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X |
Profile Details
| NPI number | 1952343196 |
|---|---|
| LBN Legal business name | Green, Tia Jaelaine |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Aug 28th, 2023 - about last year |
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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