Provider Demographics
NPI:1881994010
Name:GRAU, ERIK MICHAEL (MFA, BA)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:MICHAEL
Last Name:GRAU
Suffix:
Gender:M
Credentials:MFA, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 SAVIN HILL AVE # A32
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1083
Mailing Address - Country:US
Mailing Address - Phone:262-215-7140
Mailing Address - Fax:
Practice Address - Street 1:460 TOTTEN POND RD
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1991
Practice Address - Country:US
Practice Address - Phone:781-895-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst