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Individual

LISSA DEE GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LDN,CDCES

Contact information

Practice address
9 RICHLAND MEDICAL PARK DR STE 230, COLUMBIA, SC 29203-6859
(803) 434-7990
(803) 434-4669
Mailing address
300 E MCBEE AVE, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
182
SC
133V00000X
Registered Dietitian
715365
MI

Other

Enumeration date
03/15/2023
Last updated
06/01/2023
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