Provider Demographics
NPI:1528286036
Name:GRAVES, KAREN (MSCCC-A)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:MSCCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5817 SCHELL CIR
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-4816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3542 BRODHEAD RD
Practice Address - Street 2:KENNETH B. SKOLNICK M.D.
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3126
Practice Address - Country:US
Practice Address - Phone:724-728-6410
Practice Address - Fax:724-728-6412
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT001020L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA297960OtherBLUE SHIELD