Provider Demographics
NPI:1053564328
Name:BATSON-HOLDER, GRACE (ED D)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:BATSON-HOLDER
Suffix:
Gender:F
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10580 FLATLANDS 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4618
Mailing Address - Country:US
Mailing Address - Phone:718-473-5298
Mailing Address - Fax:
Practice Address - Street 1:10580 FLATLANDS 10TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4618
Practice Address - Country:US
Practice Address - Phone:718-473-5298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3261010312355S0801X
NY928930991103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant