Provider Demographics
NPI:1972229086
Name:GRAVES, JAMILA
Entity type:Individual
Prefix:MS
First Name:JAMILA
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 ROCKSPRING RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1659
Mailing Address - Country:US
Mailing Address - Phone:419-810-5084
Mailing Address - Fax:
Practice Address - Street 1:2335 ROCKSPRING RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1659
Practice Address - Country:US
Practice Address - Phone:419-810-5084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker
No175L00000XOther Service ProvidersHomeopathGroup - Single Specialty
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult Companion