Provider Demographics
NPI:1205515673
Name:YOUNG-GRAVES, STEPHANIE (MA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:YOUNG-GRAVES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 E WASHINGTON LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-1229
Mailing Address - Country:US
Mailing Address - Phone:215-549-5900
Mailing Address - Fax:215-548-8886
Practice Address - Street 1:1909 E WASHINGTON LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-1229
Practice Address - Country:US
Practice Address - Phone:215-549-5900
Practice Address - Fax:215-548-8886
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator