Provider Demographics
NPI:1093341646
Name:GRAHL, CANDACE STINNETT
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:STINNETT
Last Name:GRAHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102A OCEOLA AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3114
Mailing Address - Country:US
Mailing Address - Phone:434-426-7704
Mailing Address - Fax:
Practice Address - Street 1:2400 WHITE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2235
Practice Address - Country:US
Practice Address - Phone:615-460-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool