| NPI | 1982075818 |
|---|---|
| Former Name | KIMBERLY ANN GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AL 3863) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202005953) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-12-14 |