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NPI Code Detail

MEDICARE: TINA L GRAW MA

MEDICARE: TINA L GRAW MA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1225803778
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA L GRAW MA
Provider Business Mailing Address
First Line : 1616 DONOVAN DR
Second Line :
City : DUBUQUE
State : IA
Zip : 52002-2641
Country : US
Telephone Number : 563-321-6647
Fax Number :
Provider Business Practice Location Address
First Line : 1225 E RIVER DR STE 330
Second Line :
City : DAVENPORT
State : IA
Zip : 52803-5761
Country : US
Telephone Number : 563-424-0136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2023
Last Update Date : 11/15/2023

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Directions to “ TINA L GRAW MA” Practice Location

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