Individual
DR. LISA MELLISA GREENE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5100 AUTH WAY, KAISER PERMANENTE MARLOW HEIGHTS MEDICAL CENTER, SUITLAND, MD 20746-4207
(301) 702-5000
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
04392
MD
103TC0700X
Clinical Psychologist
PSY1000375
DC
Other
Enumeration date
07/30/2007
Last updated
06/02/2021
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