Provider Demographics
NPI:1225040736
Name:GRAVES, RUTH E (PHD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:E
Last Name:GRAVES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060-0001
Mailing Address - Country:US
Mailing Address - Phone:202-865-7499
Mailing Address - Fax:202-865-3875
Practice Address - Street 1:2139 GEORGIA NW AVE 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3006
Practice Address - Country:US
Practice Address - Phone:202-865-7499
Practice Address - Fax:202-865-3875
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000328103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPSY1000328OtherLICENSE