Individual
JACOB GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6000
Mailing address
5003 SOUTHWOOD DR, GODFREY, IL 62035-1338
(618) 570-0928
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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