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General NPI Number Information
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NPI Number | 1851687438
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Entity Type | Individual
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Provider Name | KRISTINA M GRAHAM MA, NCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1824 ROANE STATE HWY # 157
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City | HARRIMAN
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State | TN
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Zip | 37748-8307
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Country | US
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Telephone | 307-206-5211
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Fax |
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Provider Business Mailing Address
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Address Line | 1824 ROANE STATE HWY # 157
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City | HARRIMAN
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State | TN
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Zip | 37748-8307
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Country | US
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Telephone | 307-206-5211
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7544
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1186
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License Number State | WY
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