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
Mailing address17 E Cherry, Sumrall, MS 39482-0400

Other providers in Sumrall