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Individual

GRACE M. ABRAHAM LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8043 WINDING WOOD RD APT 14, GLEN BURNIE, MD 21061-6539
(443) 449-9991
Mailing address
8043 WINDING WOOD RD APT 14, GLEN BURNIE, MD 21061-6539
(443) 449-9991

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC8137
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1295187540
MD
05
A-165-288-566-121
MD
Enumeration date
07/11/2016
Last updated
01/16/2019
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