Individual
MRS. CRYSTAL LEIGH GRAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
LINCOLN COUNTY REORGANIZED, 951 W COLLEGE ST, TROY, MO 63379-1112
(636) 528-7652
(636) 528-2411
Mailing address
951 W COLLEGE ST, TROY, MO 63379-1112
(636) 528-7652
(636) 528-2411
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2002007285
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467510301
—
MO
Enumeration date
03/27/2007
Last updated
02/20/2009
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