Doctor Name: | KAITLYN GRAHAM |
NPI Number: | 1316171721 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | TSLP6130 |
Business Practice Address: | 210 S 6th St Buckeye, AZ - 853262830 |
Business Phone Number: | 6233864487 |
Business Fax Number: | |
Mailing Address: | 20050 N Cave Creek Rd Apt 355, PHOENIX |
State: | AZ |
Postal Code: | 850245432 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/13/2009 |
NPI Last Update Date: | 05/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | TSLP6130 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |