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

Ely Anthony Green, OTA/L

Individual provider Occupational Therapy Assistant · NPI 1174716260

Ely Anthony Green, OTA/L is an Occupational Therapy Assistant in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.

Licensed in
MS
In the registry since
2007

Practice location Address checks out

13 Northtown Dr Ste 110
Jackson, MS 39211-3047
Phone: (601) 206-9195
Fax: (601) 957-8391
Show map & directions

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

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence TA1448 (MS)

Record details

NPI number1174716260
Entity typeIndividual (Type 1)
GenderMale
Credentials OTA/L
Sole proprietorNo
NPI enumeratedAugust 22, 2007
Last updated in NPPESAugust 22, 2007

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