Provider Demographics
NPI:1598209751
Name:GRAVES-RUFFIN, HERMIONE
Entity Type:Individual
Prefix:
First Name:HERMIONE
Middle Name:
Last Name:GRAVES-RUFFIN
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 1:1952 SPRING DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-3486
Mailing Address - Country:US
Mailing Address - Phone:919-557-6967
Mailing Address - Fax:
Practice Address - Street 1:1952 SPRING DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3486
Practice Address - Country:US
Practice Address - Phone:919-557-6967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)