Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Codie Jaclyn Green

Individual provider Speech-Language Pathologist · NPI 1225769482

Codie Jaclyn Green is a Speech-Language Pathologist in Sumrall, Mississippi. Practices as a sole proprietor and works from 2 locations. Licensed in Mississippi.

Licensed in
MS
In the registry since
2022

Practice location Address checks out

668 Old Salt Rd
Sumrall, MS 39482-4232
Phone: (601) 270-6968
Fax: (601) 336-5255
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4805 W 4th St, Hattiesburg, MS 39402-1019 — (601) 270-6968

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence S-4294 (MS)

Record details

NPI number1225769482
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 20, 2022
Last updated in NPPESJune 20, 2022
Certification dateJune 20, 2022

Other providers in Sumrall