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Individual

CHARLES BEVAUN GRAVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2500 E STATE BLVD, FORT WAYNE, IN 46805-4728
(260) 426-5431
(260) 421-1029
Mailing address
8844 WINCHESTER RD, FORT WAYNE, IN 46819-2254
(260) 440-9864

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34009069A
IN

Other

Enumeration date
03/30/2021
Last updated
03/30/2021
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