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Individual
DR. GRACE PARK
Active
Individual
DR. GRACE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., PH.D.
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
04742
MD
235Z00000X
Speech-Language Pathologist
2202004766
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
831BSY
CAREFIRST BCBS
MD
01
—
9350944
CIGNA
MD
01
—
K515-0001
CAREFIRST BCBS GHMSI
DC
01
—
K515-0001
CAREFIRST BCBS GHMSI
MD
Enumeration date
05/14/2007
Last updated
07/08/2007
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