Provider Demographics
NPI:1194253211
Name:DALE, ALLISON GRACE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:GRACE
Last Name:DALE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:GRACE
Other - Last Name:GREANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:10753 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4535
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10753 FALLS RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4535
Practice Address - Country:US
Practice Address - Phone:410-583-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26047225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist