Individual
MR. CHARLES CORTLEY GRAVENGOOD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4998 ANDROS DR, NAPLES, FL 34113-7420
(702) 469-2166
Mailing address
4998 ANDROS DR, NAPLES, FL 34113-7420
(702) 469-2166
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH22145
FL
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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