Individual
KAITLYN DARLENE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 465-3203
Mailing address
4508 ABBOTT GROVE PL, CRESTWOOD, KY 40014-8436
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
235Z00000X
SPEECH-LANGUAGE PATHOLOGIST
KY
Enumeration date
01/16/2019
Last updated
01/16/2019
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