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Individual

JENDAYO GRADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
7307 BALTIMORE AVE STE 214, COLLEGE PARK, MD 20740-3231
(240) 515-5353
Mailing address
PO BOX 3740, SILVER SPRING, MD 20918-3740
(240) 515-5353

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PSY1000361
DC
103TC0700X
Clinical Psychologist
04212
MD
103TC0700X
Clinical Psychologist
PSY1000361
DC

Other

Enumeration date
05/03/2007
Last updated
07/19/2007
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