Individual
MRS. KAYLENE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2766 11 MILE RD, BERKLEY, MI 48072-3033
(248) 542-2424
Mailing address
2721 LITTLETELL AVE, WEST BLOOMFIELD, MI 48324-1755
(248) 732-7231
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703101850
MI
Other
Enumeration date
12/31/2009
Last updated
12/31/2009
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