Basic Information
| Provider Information | |||||||||
| NPI: | 1619238979 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STOKES | ||||||||
| FirstName: | GRETCHEN | ||||||||
| MiddleName: | J | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 RUMFORD DR | ||||||||
| Address2: | UNIT 203 | ||||||||
| City: | CATONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212284080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9013711114 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1111 E COLD SPRING LN | ||||||||
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| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212393932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103230500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2012 | ||||||||
| LastUpdateDate: | 06/04/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 05843 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.