Provider Demographics
NPI:1013160985
Name:GRAVES-OWENS, SILVIA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:ANN
Last Name:GRAVES-OWENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WATERTON WAY
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7153
Mailing Address - Country:US
Mailing Address - Phone:864-569-1329
Mailing Address - Fax:864-963-4575
Practice Address - Street 1:113 WATERTON WAY
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-7153
Practice Address - Country:US
Practice Address - Phone:864-569-1132
Practice Address - Fax:864-967-3214
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC626235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0123456789Medicaid