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Individual

MISHA GRAVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
482 S LANDMARK AVE, BLOOMINGTON, IN 47403-5000
(812) 333-8474
Mailing address
1311 S RECHTER CT, BLOOMINGTON, IN 47401-6173
(812) 369-5704

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary

Other

Enumeration date
07/15/2020
Last updated
07/15/2020
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