Individual
IZETTA NICHOLE GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S CHEROKEE ST, MORRILTON, AR 72110-2656
(479) 495-5177
Mailing address
100 S CHEROKEE ST, MORRILTON, AR 72110-2656
(479) 495-5177
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/10/2010
Last updated
02/10/2010
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