Individual
ANTONNETTE V GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3944
(440) 449-1555
Mailing address
5910 LANDERBROOK DR, SUITE 250, MAYFIELD HTS, OH 44124-6508
(440) 684-5829
(440) 449-1555
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1.0002629
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000311189
ANTHEM
OH
Enumeration date
07/17/2006
Last updated
07/08/2007
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