Individual
KATHY GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
690 E WARNER RD STE 105, GILBERT, AZ 85296-3055
(480) 820-6366
Mailing address
1214 S 78TH ST, MESA, AZ 85209-3479
(480) 710-7551
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0260
AZ
Other
Enumeration date
01/27/2014
Last updated
01/27/2014
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