Provider Demographics
NPI:1265077713
Name:GRAVES, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19134 ENGLISH LAKE LN
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7202
Mailing Address - Country:US
Mailing Address - Phone:317-627-2745
Mailing Address - Fax:
Practice Address - Street 1:18 E MAIN ST STE 216
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-5541
Practice Address - Country:US
Practice Address - Phone:317-649-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist