Individual
LATRICE KIANE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW-C, RPT
Contact information
Practice address
5304 CEDAR DR, CAMBRIDGE, MD 21613-4404
(410) 929-7427
Mailing address
5304 CEDAR DR, CAMBRIDGE, MD 21613-4404
(410) 929-7427
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
18674
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18674
MARYLAND BOARD OF SOCIAL WORK
MD
Enumeration date
07/24/2017
Last updated
11/03/2020
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