Green, Jerry Wayne
Green, Jerry Wayne is an sole proprietor health care provider with primary practice located at 2463 Waterside Dr , Grand Prairie TX 75054-6806. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Green, Jerry Wayne can be contacted via phone (817) 673-2183.Contact Information
Primary practice address
2463 Waterside Dr
Grand Prairie TX 75054-6806
Phone: (817) 673-2183
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 14932 | Texas |
Profile Details
| NPI number | 1992361497 |
|---|---|
| LBN Legal business name | Green, Jerry Wayne |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2019 |
| Last updated | May 10th, 2019 - about 7 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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