Individual
FREDERIC MASADA GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
914 BAUMANN DR, GRAND ISLAND, NE 68803-4401
(308) 390-2664
(308) 385-5271
Mailing address
914 BAUMANN DR, GRAND ISLAND, NE 68803-4401
(308) 390-2664
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
13632
NE
101YM0800X
Mental Health Counselor
3167
NE
101YM0800X
Mental Health Counselor
Primary
4516
NE
Other
Enumeration date
10/05/2023
Last updated
03/24/2026
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