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NPI Code Detail

MEDICARE: MEREDITH GRAU LMHC

MEDICARE: MEREDITH GRAU LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorMH11945FL
2101YM0800XMental Health CounselorIMH-8472FL

General Provider Information

NPI Number : 1083996052
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEREDITH GRAU LMHC
Provider Business Mailing Address
First Line : 126 LITHIA PINECREST RD
Second Line :
City : BRANDON
State : FL
Zip : 33511-5347
Country : US
Telephone Number : 813-815-0939
Fax Number :
Provider Business Practice Location Address
First Line : 126 LITHIA PINECREST RD
Second Line :
City : BRANDON
State : FL
Zip : 33511-5347
Country : US
Telephone Number : 813-815-0939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2011
Last Update Date : 11/28/2016

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