Individual
GRACE MALLONEE LOMAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 BURKHARDT LN, SEVERN, MD 21144-2800
(443) 763-9052
Mailing address
1104 BURKHARDT LN, SEVERN, MD 21144-2800
(443) 763-9052
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A03081
MD
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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