Provider Demographics
NPI:1295009397
Name:ANNE MORGAN GRAY LTD
Entity type:Organization
Organization Name:ANNE MORGAN GRAY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KORNBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-452-3449
Mailing Address - Street 1:5305 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1413
Mailing Address - Country:US
Mailing Address - Phone:301-897-9591
Mailing Address - Fax:
Practice Address - Street 1:5305 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1413
Practice Address - Country:US
Practice Address - Phone:301-897-9591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD036631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty