Most Relevant Information
Provider Data
| NPI Number: | 1003661141 |
| Provider Name: | JUKENDRA GREEN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/22/2024 |
| Last Updated: | 04/22/2024 |
Provider Practice Location
29691 6 MILE RD STE 100D
LIVONIA
MI
481528606
Practice Location Phone/Fax
| Phone: | 8667278274 |
| Fax: |
Provider Mailing Location
2550 N HOLLYWOOD WAY STE 301
BURBANK
CA
915055025
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |