Individual
MICHELLE NICOLE GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1529 NYE RD, LYONS, NY 14489-9111
(315) 946-5646
Mailing address
159 W 1ST ST, OSWEGO, NY 13126-2045
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007696
NY
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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