Individual
MADELEINE KAYNE GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P-LPC
Contact information
Practice address
7075 GOLDEN OAKS LOOP W, SOUTHAVEN, MS 38671-9010
(662) 228-0130
Mailing address
7075 GOLDEN OAKS LOOP W, SOUTHAVEN, MS 38671-9010
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P-1038
MS
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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