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NPI Code Detail

MEDICARE: GRACE MARIE SANTANDREU

MEDICARE: GRACE MARIE SANTANDREU
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
1101Y00000XCounselor
2106H00000XMarriage & Family TherapistLGM955MD

General Provider Information

NPI Number : 1972173557
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE MARIE SANTANDREU
Provider Business Mailing Address
First Line : 8181 MAIN ST APT 2
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-4929
Country : US
Telephone Number : 410-505-0062
Fax Number :
Provider Business Practice Location Address
First Line : 8181 MAIN ST
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-4929
Country : US
Telephone Number : 410-505-0062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2021
Last Update Date : 10/20/2023

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Directions to “ GRACE MARIE SANTANDREU ” Practice Location

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