Greene, Jill M

Greene, Jill M is an individual health care provider with primary practice located at 6075 N Stafford Pl , Boise ID 83713-2074. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Greene, Jill M can be contacted via phone (802) 233-6582.

Contact Information

Primary practice address
6075 N Stafford Pl Boise ID 83713-2074
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-03-1242

Profile Details

NPI number 1316265952
LBN Legal business name Greene, Jill M
Credentials MA, BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2010
Last updated May 6th, 2010 - about 14 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 1316265952 NPPES
Idaho Other 800548272-83713-0000 TRICARE

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