Provider Demographics
NPI:1881842631
Name:GRAVES, PAMELA J (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:GRAVES
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 DAUPHIN ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1756
Mailing Address - Country:US
Mailing Address - Phone:251-341-3368
Mailing Address - Fax:251-445-7724
Practice Address - Street 1:3701 DAUPHIN ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1756
Practice Address - Country:US
Practice Address - Phone:251-341-3368
Practice Address - Fax:251-445-7724
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL829-A231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter