Individual
THERESA GRAHAM-MINEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
740 N 15TH AVE, STE A, HIAWATHA, IA 52233-2384
(319) 398-3562
(319) 398-3501
Mailing address
520 11TH ST NW, CEDAR RAPIDS, IA 52405-3811
(319) 398-3562
(319) 398-3501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001725
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074575
—
IA
Enumeration date
02/26/2015
Last updated
02/26/2015
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