Individual
STACEY LYNN GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
913 SW HIGGINS AVE STE 202, MISSOULA, MT 59803-1423
(406) 690-7753
Mailing address
PO BOX 7874, MISSOULA, MT 59807-7874
(406) 690-7753
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
BBH-LCPC-LIC-18899
MT
Other
Enumeration date
05/01/2017
Last updated
08/31/2020
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