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General NPI Number Information
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NPI Number | 1811404130
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Entity Type | Individual
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Provider Name | LEARA M GRAVES L.AC
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Gender | Female
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 5820 YORK RD STE 201
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City | BALTIMORE
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State | MD
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Zip | 21212-3620
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Country | US
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Telephone | 410-800-2169
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Fax |
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Provider Business Mailing Address
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Address Line | 1370 SAINT NICHOLAS AVE APT 18S
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City | NEW YORK
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State | NY
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Zip | 10033-6231
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Country | US
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Telephone | 646-639-3408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 005705-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 020384-01
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License Number State | NY
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