MEDICARE: JULISSA SADE GREGORY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1588522155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULISSA SADE GREGORY

Provider Business Mailing Address
First Line	:	7019 GEORGIA AVE NW APT 507
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-2435
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 SPRING ST, SUITE 101
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910
Country	:	US
Telephone Number	:	240-398-3514
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ JULISSA SADE GREGORY ” Practice Location

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