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General NPI Number Information
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NPI Number | 1760208987
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Entity Type | Individual
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Provider Name | MARY CATHERINE ROSS-GRAY PHD
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Gender | Female
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 835 46TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20019-3654
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Country | US
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Telephone | 301-605-4486
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Fax |
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Provider Business Mailing Address
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Address Line | 12910 PISCATAWAY LANDING DR
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City | CLINTON
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State | MD
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Zip | 20735-4592
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Country | US
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Telephone | 301-605-4486
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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 | CER-193555-N6B3N2
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | CER-193555-N6B3N2
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License Number State | MD
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