Provider Demographics
NPI:1578584363
Name:GRACE, KATHY A (AUD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:A
Last Name:GRACE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 ELTON RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903
Mailing Address - Country:US
Mailing Address - Phone:301-434-4300
Mailing Address - Fax:301-434-6299
Practice Address - Street 1:1734 ELTON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903
Practice Address - Country:US
Practice Address - Phone:301-434-4300
Practice Address - Fax:301-434-6299
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD897231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC31570004OtherBCBS
MD61732504OtherBCBS
299530OtherMAMSI
299530OtherMAMSI