Provider Demographics
NPI:1386000909
Name:MORAN-GRAP, LYNN
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:MORAN-GRAP
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 1:42 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2410
Mailing Address - Country:US
Mailing Address - Phone:410-570-0011
Mailing Address - Fax:410-544-9488
Practice Address - Street 1:42 HOLLY RD
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2410
Practice Address - Country:US
Practice Address - Phone:410-570-0011
Practice Address - Fax:410-544-9488
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01609235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist