Provider Demographics
NPI:1528236767
Name:GRAVES, SUZANNE B (MA, MT-BC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:B
Last Name:GRAVES
Suffix:
Gender:F
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1301
Mailing Address - Country:US
Mailing Address - Phone:610-291-7284
Mailing Address - Fax:
Practice Address - Street 1:1311 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-1301
Practice Address - Country:US
Practice Address - Phone:610-291-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA08033OtherCMBT CERTIFICATION NUMBER