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NPI Code Detail

MEDICARE: VICTORIA GRAVES

MEDICARE:   VICTORIA  GRAVES
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
11041C0700XClinical Social Worker2025020885MO

General Provider Information

NPI Number : 1700770351
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA GRAVES
Provider Business Mailing Address
First Line : 1000 EXECUTIVE PARKWAY DR
Second Line :
City : CREVE COEUR
State : MO
Zip : 63141-6325
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 EXECUTIVE PARKWAY DR
Second Line :
City : CREVE COEUR
State : MO
Zip : 63141-6325
Country : US
Telephone Number : 314-469-5522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2025
Last Update Date : 06/06/2025

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Directions to “ VICTORIA GRAVES ” Practice Location

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