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General NPI Number Information
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NPI Number | 1992451439
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Entity Type | Individual
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Provider Name | MRS. CARA NAOMI GRAHAM
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Gender | Female
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 1829 WOODVINE ST APT 6
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City | FAIRBORN
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State | OH
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Zip | 45324-6610
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Country | US
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Telephone | 734-787-8625
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 624
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City | EATON
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State | OH
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Zip | 45320-0624
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2202360-TRNE
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License Number State | OH
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