Provider Demographics
NPI:1598790594
Name:GREEN-BROWN, JILL ANN (MA, LLP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:ANN
Last Name:GREEN-BROWN
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 S WESTNEDGE AVE STE 2205
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3287
Mailing Address - Country:US
Mailing Address - Phone:269-372-4500
Mailing Address - Fax:269-372-7230
Practice Address - Street 1:4341 S WESTNEDGE AVE STE 2205
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3287
Practice Address - Country:US
Practice Address - Phone:269-372-4500
Practice Address - Fax:269-372-7230
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010998103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling