Individual
TERESA MARIE GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
4001 W GLENN ST, BOISE, ID 83705-1421
(208) 695-8063
Mailing address
4001 W GLENN ST, BOISE, ID 83705-1421
(208) 695-8063
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
ID
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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