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General NPI Number Information
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NPI Number | 1699577676
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Entity Type | Individual
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Provider Name | GLENNA KWAME-GREENE
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Gender | Female
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 11402 COVERED BRIDGE CT
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City | GLENN DALE
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State | MD
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Zip | 20769-9130
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Country | US
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Telephone | 301-814-0037
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Fax | 301-814-0037
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Provider Business Mailing Address
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Address Line | 11402 COVERED BRIDGE CT
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City | GLENN DALE
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State | MD
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Zip | 20769-9130
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Country | US
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Telephone | 301-814-0037
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Fax | 877-408-0066
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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Taxonomy #3
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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Taxonomy #4
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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Taxonomy #5
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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Taxonomy #6
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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Taxonomy #7
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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