Individual
DR. PATRICIA ANNA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD., HSPP
Contact information
Practice address
1112 US HIGHWAY 41 STE 108, SCHERERVILLE, IN 46375-1361
(773) 501-3557
Mailing address
3831 KIRK ST, SKOKIE, IL 60076-3419
(773) 501-3557
(773) 501-3557
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071007159
IL
103TC0700X
Clinical Psychologist
Primary
20042049A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000363699
ANTHEM BLUE CROSS
IA
01
—
060132-000
MAGELLAN
IN
05
—
200818220
—
IN
Enumeration date
08/09/2005
Last updated
10/30/2023
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