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General NPI Number Information
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NPI Number | 1255387973
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Entity Type | Individual
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Provider Name | GRACE R STROUD M.A.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 03/10/2018
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Provider Practice Location Address
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Address Line | 3948 BROWNING PL
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City | RALEIGH
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State | NC
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Zip | 27609-6512
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Country | US
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Telephone | 919-783-6776
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Fax | 919-783-6776
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Provider Business Mailing Address
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Address Line | 1005 MILLS ST
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City | RALEIGH
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State | NC
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Zip | 27608-1833
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Country | US
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Telephone | 919-818-3689
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2003
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License Number State | NC
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