Kenneth Jerome Graves in Dallas - Clinical Child & Adolescent
Kenneth Jerome Graves - NPI 1275689416
Kenneth Jerome Graves is a Clinical Child & Adolescent in Dallas, Texas. Kenneth Jerome Graves practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Kenneth Jerome Graves is 1275689416. The last update date is 2018-04-16.
Kenneth Jerome Graves's current location address is 1005 W Jefferson Blvd, Dallas, Texas. You can contact this provider via phone number 2149164025. The mailing address for Kenneth Jerome Graves is 1005 W Jefferson Blvd, Dallas, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Jerome Graves |
|---|---|
| Address | 1005 W Jefferson Blvd, Dallas, Texas |
| Phone Number | 2149164025 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1275689416 |
|---|---|
| Provider Enumeration Date | 2007-01-27 |
| Last Updated Date | 2018-04-16 |
Provider Mailing Address Detail
| Address | 1005 W Jefferson Blvd |
|---|---|
| City | Dallas |
| State | Texas (TX) |
| Post Code | 752085087 |
| Phone Number | 2149164025 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
| Licence No | 30557 |
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Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0962334-01 | TX | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Kenneth Jerome Graves?
The Kenneth Jerome Graves has been issued the NPI (National Provider Identifier) 1275689416 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Kenneth Jerome Graves is physically located?
The Kenneth Jerome Graves is physically situated at the following address: 1005 W Jefferson Blvd, Dallas, TX, 752085087.
What is Kenneth Jerome Graves's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kenneth Jerome Graves is Clinical Child & Adolescent, and the taxonomy classification code that categorizes this area of expertise is 103Tc2200X.
On what date was the 1275689416 assigned to Kenneth Jerome Graves?
The Kenneth Jerome Graves was issued its 1275689416 on 2007-01-27, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Kenneth Jerome Graves, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Kenneth Jerome Graves, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2018-04-16.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC