MEDICARE: CASSY GRAHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker		OH

General Provider Information

NPI Number	:	1306702725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSY GRAHAM

Provider Business Mailing Address
First Line	:	2915 WESTDALE RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-1250
Country	:	US
Telephone Number	:	330-432-0114
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 WESTDALE RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-1250
Country	:	US
Telephone Number	:	330-432-0114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	12/30/2025

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Directions to “ CASSY GRAHAM ” Practice Location

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