Individual
DR. SAMUEL LEE GRAHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1000 73RD ST, WINDSOR HEIGHTS, IA 50311-1321
(515) 222-1175
(515) 222-0953
Mailing address
1000 73RD ST, WINDSOR HEIGHTS, IA 50311-1321
(515) 222-1175
(515) 222-0953
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
435/160
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421355536-26
—
IA
Enumeration date
08/12/2005
Last updated
07/08/2007
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