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1225606890
OMEGA DENISE GRAHAM
LAKE CITY, SC
NPI
1225606890
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: SC 24831)
Enumeration Date
2021-06-11
Last Update Date
2021-06-11
Business Address
Mrs. OMEGA DENISE GRAHAM PMHNP
378 WALLACE ST
LAKE CITY, SC 29560-4108
Phone number: 843-373-0569
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Mailing Address
Mrs. OMEGA DENISE GRAHAM PMHNP
PO BOX 901
LAKE CITY, SC 29560-0901
Phone number: 843-373-0569
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