Doctor Name: | CARLA ADDISON GRAHAM |
NPI Number: | 1154669018 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | SLP007429 |
Business Practice Address: | 104 Flat Tail Way Greer, SC - 296512807 |
Business Phone Number: | 5405250310 |
Business Fax Number: | |
Mailing Address: | 104 Flat Tail Way, GREER |
State: | SC |
Postal Code: | 296512807 |
Phone Number: | 5405250310 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2013 |
NPI Last Update Date: | 02/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP007429 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |