| NPI | 1104227610 |
|---|---|
| Former Name | STEPHANIE DAWN GRAVES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 110426) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 13414) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-09-16 |