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General NPI Number Information
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NPI Number | 1912102138
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Entity Type | Individual
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Provider Name | CANDICE GRAVES
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 389 WASHINGTON ST APT 1
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City | NORWOOD
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State | MA
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Zip | 02062-2341
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Country | US
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Telephone | 617-892-5838
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Fax |
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Provider Business Mailing Address
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Address Line | 389 WASHINGTON ST APT 1
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City | NORWOOD
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State | MA
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Zip | 02062
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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