| Doctor Name: | DR. GRACE PARK |
| NPI Number: | 1114132743 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., PH.D. |
| License Number: | 2202004766 |
| Business Practice Address: | 932 Hungerford Dr Suite 29a Rockville, MD - 208501713 |
| Business Phone Number: | 3014247701 |
| Business Fax Number: | 3014247703 |
| Mailing Address: | 932 Hungerford Dr, Suite 29a ROCKVILLE |
| State: | MD |
| Postal Code: | 208501713 |
| Phone Number: | 3014247701 |
| Fax Number: | 3014247703 |
| NPI Enumeration Date: | 05/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202004766 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |