Provider Demographics
NPI:1619493871
Name:KALAKAY, GRACE (LAC)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:KALAKAY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 MURDOCH CT
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1667
Mailing Address - Country:US
Mailing Address - Phone:410-900-0840
Mailing Address - Fax:
Practice Address - Street 1:750 MD RT 3 S STE A8
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1300
Practice Address - Country:US
Practice Address - Phone:410-900-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-19
Last Update Date:2017-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02441171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist