Individual
PATRICK JOSEPH GRAVELINE
Active
Individual
PATRICK JOSEPH GRAVELINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D., BCBA-D
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
Primary
4582
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252502000
—
MD
Enumeration date
02/06/2007
Last updated
07/21/2022
Update your record
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