Individual
MS. KORI DIANE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1501 E GREENVILLE ST, ANDERSON, SC 29621-2004
(864) 226-8356
Mailing address
346 S HARRISON BRIDGE RD, SIMPSONVILLE, SC 29680-6802
(864) 313-4557
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2557
SC
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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