Individual
MS. ELISABETH ANN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
19465 DEERFIELD AVE STE 201, LANSDOWNE, VA 20176-1703
(703) 858-7620
Mailing address
16846 CHESTNUT OVERLOOK DR, PURCELLVILLE, VA 20132-2875
(703) 864-5824
(703) 864-5824
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202003690
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4978196
—
VA
Enumeration date
01/30/2007
Last updated
06/05/2019
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