MEDICARE: MS. LYNN L GRAVES CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	7665	TN
2	235Z00000X	Speech-Language Pathologist	32380	CA

General Provider Information

NPI Number	:	1164683223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNN L GRAVES CCC-SLP

Provider Business Mailing Address
First Line	:	422 ALTER TER
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-3869
Country	:	US
Telephone Number	:	205-919-4448
Fax Number	:

Provider Business Practice Location Address
First Line	:	422 ALTER TER
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-3869
Country	:	US
Telephone Number	:	205-919-4448
Fax Number	:	999-999-9999

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2008
Last Update Date	:	06/04/2026

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