# THEONI S GRAHAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1992730691
- **Gender:** F
- **Credential:** M.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 2201000216 | VA | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 01/08/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0723576002 | CIGNA PROVIDER NUMBER | VA |
| 01 | — | 148932100 | DEPT OF LABOR PROVIDER | VA |
| 01 | — | 386056 | ANTHEM PROVIDER NUMBER | VA |
| 01 | — | 51143 | SENTARA/OPTIMA PROVIDER | VA |
| 01 | — | 540972387 | AETNA/TRICARE PROVIDER | VA |
| 01 | — | 640004704 | MEDICARE RAILROAD PROVIDE | VA |