Provider Demographics
NPI:1093097966
Name:GRAVES, ANITA G (BA, QP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:G
Last Name:GRAVES
Suffix:
Gender:F
Credentials:BA, QP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 RUDD ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-2957
Mailing Address - Country:US
Mailing Address - Phone:336-513-4229
Mailing Address - Fax:336-513-4228
Practice Address - Street 1:405 RUDD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2957
Practice Address - Country:US
Practice Address - Phone:336-513-4229
Practice Address - Fax:336-513-4228
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker