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NPI Code Detail

MEDICARE: SHEILA MARIE GRAHAM

MEDICARE:   SHEILA MARIE 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
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407191547
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEILA MARIE GRAHAM
Provider Business Mailing Address
First Line : 1220 W MONROE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2859
Country : US
Telephone Number : 702-271-5643
Fax Number :
Provider Business Practice Location Address
First Line : 1220 W MONROE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2859
Country : US
Telephone Number : 702-271-5643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2012
Last Update Date : 11/29/2012

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Directions to “ SHEILA MARIE GRAHAM ” Practice Location

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