Individual
KIMBERLI GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1311 N DIXIE HWY, ELIZABETHTOWN, KY 42701-2621
(270) 769-1304
(270) 234-8028
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 766-1222
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0809
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11574917
CAQH
—
05
—
30605018
—
KY
Enumeration date
06/05/2006
Last updated
07/16/2014
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