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General NPI Number Information
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NPI Number | 1023574035
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Entity Type | Individual
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Provider Name | KIERA E GRAHAM LPC
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Gender | Female
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 10427 DETROIT AVE
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City | CLEVELAND
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State | OH
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Zip | 44102-1645
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Country | US
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Telephone | 216-694-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 3445 GREEN RD
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City | BEACHWOOD
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State | OH
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Zip | 44122-7708
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Country | US
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Telephone | 216-315-3592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C1902382
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License Number State | OH
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