Provider Demographics
NPI:1578798146
Name:GRABER, NANCY LEE (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LEE
Last Name:GRABER
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S DALE MABRY HWY
Mailing Address - Street 2:SUITE 256
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2820
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:405 S DALE MABRY HWY
Practice Address - Street 2:SUITE 256
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2820
Practice Address - Country:US
Practice Address - Phone:877-226-5958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5918101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health