Provider Demographics
NPI:1821343559
Name:GRAVES, TERRI (MSCF-SLP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:MSCF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 PINON DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-9408
Mailing Address - Country:US
Mailing Address - Phone:501-388-1342
Mailing Address - Fax:
Practice Address - Street 1:128 PINON DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-9408
Practice Address - Country:US
Practice Address - Phone:501-388-1342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist