Individual
JEAN ANN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2503 SARATOGA DR, AUSTIN, TX 78733-1240
(512) 299-1500
Mailing address
PO BOX 340744, AUSTIN, TX 78734-0013
(512) 299-1500
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
1835N1003X
Nutrition Support Pharmacist
Primary
21955
TX
374U00000X
Home Health Aide
—
—
Other
Enumeration date
06/12/2018
Last updated
06/12/2018
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