Provider Demographics
NPI:1790191351
Name:GARCIA-CATIPON, GRATA REGINA VICTORI (MA, MED)
Entity Type:Individual
Prefix:
First Name:GRATA REGINA VICTORI
Middle Name:
Last Name:GARCIA-CATIPON
Suffix:
Gender:F
Credentials:MA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11406 PIEDMONT CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-9371
Mailing Address - Country:US
Mailing Address - Phone:301-528-5214
Mailing Address - Fax:301-540-8454
Practice Address - Street 1:20300 SENECA MEADOWS PKWY
Practice Address - Street 2:# 215
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7010
Practice Address - Country:US
Practice Address - Phone:301-528-5214
Practice Address - Fax:301-540-8454
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDLC5533101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor