Individual
MELA GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7261 W CHARLESTON BLVD STE 101, LAS VEGAS, NV 89117-1679
(702) 396-0101
Mailing address
1380 W 48TH ST UNIT 117, SAN BERNARDINO, CA 92407-5049
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-54142
NV
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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