Individual
GILLIAN KEMBA GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
1728 INGRAM RD, BALTIMORE, MD 21239-3717
(410) 905-9904
Mailing address
1728 INGRAM RD, BALTIMORE, MD 21239-3717
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18294
MD
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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