Individual
KIMBERLY GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9649 W. 55TH STREET, COUNTRYSIDE, IL 60525-3632
(708) 352-3580
Mailing address
9649 W. 55TH STREET, COUNTRYSIDE, IL 60525-3632
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150012149
IL
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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