MISS Jalicia Chanel Green, CBT

NPI #1982473542 in Moses Lake, Washington

Provider Information

NPI Number: 1982473542
Entity Type: Individual
Name: MISS Jalicia Chanel Green, CBT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Credential: CBT
Enumeration Date: Dec 25, 2023
Last Updated: Dec 25, 2023

Practice Location

Address: 615 S DIVISION ST STE A
City: Moses Lake
State: Washington
ZIP Code: 98837-3800
Phone: (509) 764-6644

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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