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NPI Code Detail

MEDICARE: SARAH GRAHAM

MEDICARE: SARAH 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
1224Z00000XOccupational Therapy Assistant3505SC

General Provider Information

NPI Number : 1770048969
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH GRAHAM
Provider Business Mailing Address
First Line : 131 COTTONWOOD DR
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-4468
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 201 W 9TH NORTH ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-6721
Country : US
Telephone Number : 843-879-0922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2019
Last Update Date : 02/01/2019

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Directions to “ SARAH GRAHAM ” Practice Location

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