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General NPI Number Information
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NPI Number | 1609148840
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Entity Type | Organization
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Legal Business Name | DANA L. GRAHAM LCSW, PLLC
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 1800 N INTERSTATE DR STE 116 DILLARD GROUP EXECUTIVE SUITES
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City | NORMAN
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State | OK
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Zip | 73072-2995
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Country | US
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Telephone | 405-290-1436
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Fax | 405-290-1450
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Provider Business Mailing Address
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Address Line | 1800 N INTERSTATE DR STE 116 DILLARD GROUP EXECUTIVE SUITES
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City | NORMAN
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State | OK
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Zip | 73072-2995
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Country | US
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Telephone | 405-290-1436
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Fax | 405-290-1450
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Authorized Official
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Title or Position | OWNER
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Name | DANA L GRAHAM
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Credential |
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Telephone | 405-290-1436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1946
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License Number State | OK
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