Provider Demographics
NPI:1083070734
Name:GRAVES, MELANIE (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:HOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 MAMMOTH SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-6225
Mailing Address - Country:US
Mailing Address - Phone:832-444-0821
Mailing Address - Fax:
Practice Address - Street 1:1300 BAY AREA BLVD
Practice Address - Street 2:SUITE 122B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2505
Practice Address - Country:US
Practice Address - Phone:979-476-2682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist