Individual
MARY TERESA GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
817 MAIDEN CHOICE LN STE 350, CATONSVILLE, MD 21228-3692
(410) 242-9001
Mailing address
1119 VINEYARD HILL RD, CATONSVILLE, MD 21228-5377
(410) 218-3476
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R066268
MD
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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