Individual
KIMBERLY GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED CCC/SLP
Contact information
Practice address
815 KRISTEN LANE, HAHIRA, GA 31632
(229) 305-4515
Mailing address
815 KRISTEN LANE, HAHIRA, GA 31632
(229) 305-4515
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007246
GA
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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