Provider Demographics
NPI:1245451400
Name:GRAVES, DIANA JOY (2681094)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:JOY
Last Name:GRAVES
Suffix:
Gender:F
Credentials:2681094
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 KAREN CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081
Mailing Address - Country:US
Mailing Address - Phone:614-899-1653
Mailing Address - Fax:
Practice Address - Street 1:835 KAREN CT
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-899-1653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2681094171WH0202X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171WH0202XOther Service ProvidersContractorHome Modifications
Not Answered174400000XOther Service ProvidersSpecialist