Provider Demographics
NPI:1932232667
Name:NEBRES-ZUCKERMAN, GRACE ANN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:ANN
Last Name:NEBRES-ZUCKERMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W PADONIA RD
Mailing Address - Street 2:SUITE C-353
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2226
Mailing Address - Country:US
Mailing Address - Phone:240-354-3815
Mailing Address - Fax:
Practice Address - Street 1:22 W PADONIA RD
Practice Address - Street 2:SUITE C-353
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2226
Practice Address - Country:US
Practice Address - Phone:240-354-3815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD129831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical