Provider Demographics
NPI:1063004372
Name:CHOI, GRACE (MA, MT-BC)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 ALMEDA RD APT 815
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2151
Mailing Address - Country:US
Mailing Address - Phone:832-786-1637
Mailing Address - Fax:
Practice Address - Street 1:7200 ALMEDA RD APT 815
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2151
Practice Address - Country:US
Practice Address - Phone:832-786-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
15471225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist