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General NPI Number Information
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NPI Number | 1457878571
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Entity Type | Individual
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Provider Name | GRACE WHITE
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Gender | Female
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Dates
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Enumeration Date | 08/29/2017
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Last Update Date | 08/29/2017
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Provider Practice Location Address
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Address Line | 2006 WHITTAKER CT
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City | DISTRICT HEIGHTS
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State | MD
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Zip | 20747-2559
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Country | US
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Telephone | 410-294-2456
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Fax |
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Provider Business Mailing Address
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Address Line | 7325 KERRY HILL CT
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City | COLUMBIA
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State | MD
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Zip | 21045-5024
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Country | US
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Telephone |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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