Provider Demographics
NPI:1225618119
Name:GRANT, RACHEL I
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:I
Last Name:GRANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 FIDLER LN APT 722
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3414
Mailing Address - Country:US
Mailing Address - Phone:301-693-3484
Mailing Address - Fax:
Practice Address - Street 1:8701 GEORGIA AVE STE 406
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3713
Practice Address - Country:US
Practice Address - Phone:267-252-6653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50083562104100000X
MD26242104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker