Individual
DR. JERRY ALAN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1778 CENTURY BLVD NE STE B, ATLANTA, GA 30345-3398
(404) 325-8900
(404) 325-8900
Mailing address
1778 CENTURY BLVD NE STE B, ATLANTA, GA 30345-3398
(404) 325-8900
(404) 325-8900
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001933
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52486388
BLUE CROSS BLUE SHILED
GA
Enumeration date
12/06/2006
Last updated
07/08/2007
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