Healthcare Provider Details

I. General information

NPI: 1265312946
Provider Name (Legal Business Name): DR. GRACE ELIZABETH MONCURE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W BROAD ST
FALLS CHURCH VA
22046-3219
US

IV. Provider business mailing address

101 E STATE ST
KENNETT SQUARE PA
19348-3109
US

V. Phone/Fax

Practice location:
  • Phone: 703-992-9868
  • Fax:
Mailing address:
  • Phone: 856-809-3320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011058
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: