| Doctor Name: | MRS. JO ANN LANGE GRAHAM |
| NPI Number: | 1134393515 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | SW9808 |
| Business Practice Address: | 1408 N Killian Dr Ste 202 Lake Park, FL - 334031961 |
| Business Phone Number: | 5616354887 |
| Business Fax Number: | 5616888143 |
| Mailing Address: | 1408 North Killian Drive, LAKE PARK |
| State: | FL |
| Postal Code: | 33403 |
| Phone Number: | 5616354887 |
| Fax Number: | 5616888143 |
| NPI Enumeration Date: | 04/17/2008 |
| NPI Last Update Date: | 07/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW9808 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |