Organization
MICHELLE GRAVLEY, P.C.
Active
Organization
MICHELLE GRAVLEY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE GRAVLEY PSY.D. (OWNER/PRESIDENT)
(702) 212-3008
Entity
Organization
Contact information
Practice address
2445 FIRE MESA ST, SUITE 190, LAS VEGAS, NV 89128-9014
(702) 212-3008
(702) 933-3064
Mailing address
2445 FIRE MESA ST, SUITE 190, LAS VEGAS, NV 89128-9014
(702) 212-3008
(702) 933-3064
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PY0381
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002602018
—
NV
Enumeration date
11/04/2010
Last updated
11/04/2010
Update your record
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