Provider Demographics
NPI:1518724228
Name:GRAVERT-PALMER, MICHELLE L (MHA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:GRAVERT-PALMER
Suffix:
Gender:F
Credentials:MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4050 BOWLING ST SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-5005
Mailing Address - Country:US
Mailing Address - Phone:319-862-1050
Mailing Address - Fax:319-862-1052
Practice Address - Street 1:3601 16TH AVE SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-2328
Practice Address - Country:US
Practice Address - Phone:319-390-4611
Practice Address - Fax:319-390-4381
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)