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NPI Code Detail

MEDICARE: MARGARET GRAHAM

MEDICARE:   MARGARET  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
1101YP2500XProfessional CounselorE.0701150-SUPVOH

General Provider Information

NPI Number : 1780006841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET GRAHAM
Provider Business Mailing Address
First Line : 12509 MADISON AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-5004
Country : US
Telephone Number : 216-563-1754
Fax Number : 216-563-1783
Provider Business Practice Location Address
First Line : 12509 MADISON AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-5004
Country : US
Telephone Number : 216-563-1754
Fax Number : 216-563-1783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2014
Last Update Date : 01/09/2014

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