MEDICARE: MONICA GRAVES

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	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1730670589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA GRAVES

Provider Business Mailing Address
First Line	:	1029 ARIES ST
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-3263
Country	:	US
Telephone Number	:	469-254-4840
Fax Number	:

Provider Business Practice Location Address
First Line	:	1029 ARIES ST
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-3263
Country	:	US
Telephone Number	:	469-254-4840
Fax Number	:

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

Provider Enumeration Date	:	05/27/2018
Last Update Date	:	05/27/2018

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Directions to “ MONICA GRAVES ” Practice Location

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