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Individual

MR. ERIC GRAVES SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW, PIP

Contact information

Practice address
2809 CREEKSTONE LN, PHENIX CITY, AL 36867-2422
(706) 442-5270
Mailing address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
(762) 408-0255

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1099-3582C
AL
1041C0700X
Clinical Social Worker
CSW005194
GA

Other

Enumeration date
01/17/2014
Last updated
12/12/2023
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