Katie Lynn Green

NPI #1053076497 in Tyler, Texas

Provider Information

NPI Number: 1053076497
Entity Type: Individual
Name: Katie Lynn Green
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Nov 1, 2021
Last Updated: Nov 1, 2021

Practice Location

Address: 1910 E SE LOOP 323 # 382
City: Tyler
State: Texas
ZIP Code: 75701-8337
Phone: (214) 796-7641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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