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NPI Code Detail

MEDICARE: JUDITH B GRABER LICSW

MEDICARE:   JUDITH B GRABER  LICSW
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 Worker116791MA

General Provider Information

NPI Number : 1215284732
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH B GRABER LICSW
Provider Business Mailing Address
First Line : 46 STEINBECK ST
Second Line :
City : TYNGSBORO
State : MA
Zip : 01879-2729
Country : US
Telephone Number : 609-516-9564
Fax Number :
Provider Business Practice Location Address
First Line : 60 KENDRICK ST
Second Line : SUITE 204
City : NEEDHAM
State : MA
Zip : 02494-2726
Country : US
Telephone Number : 800-370-3651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2012
Last Update Date : 08/15/2012

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Directions to “ JUDITH B GRABER LICSW” Practice Location

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