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NPI Code Detail

MEDICARE: MRS. VANESSA WILSON GRAVES LCSW

MEDICARE: MRS. VANESSA WILSON GRAVES LCSW
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 Worker7247LA

General Provider Information

NPI Number : 1730332248
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VANESSA WILSON GRAVES LCSW
Provider Business Mailing Address
First Line : 2006 GUS KAPLAN DR
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3376
Country : US
Telephone Number : 318-473-0035
Fax Number :
Provider Business Practice Location Address
First Line : 2006 GUS KAPLAN DR
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3376
Country : US
Telephone Number : 318-473-0035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2008
Last Update Date : 10/28/2008

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Directions to “ MRS. VANESSA WILSON GRAVES LCSW” Practice Location

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