Individual
KATIE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSC
Contact information
Practice address
4339 WINSTON AVE, COVINGTON, KY 41015-1739
(859) 835-2573
Mailing address
4339 WINSTON AVE, COVINGTON, KY 41015-1739
(859) 835-2573
(859) 727-6327
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
130656
KY
101YM0800X
Mental Health Counselor
2013-041
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130656
—
KY
05
—
2013-041
—
KY
Enumeration date
03/25/2014
Last updated
04/06/2018
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