Individual
TAHLIA SUZANNE GRAVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPRS-T, RPRS
Contact information
Practice address
416 SWANSON ST, MARTINSVILLE, VA 24112-2533
(276) 226-6331
Mailing address
416 SWANSON ST, MARTINSVILLE, VA 24112-2533
(276) 226-6331
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0735001009
VA
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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