Provider Demographics
NPI:1124772157
Name:GRAHAM, DEBORA A
Entity type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:A
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 TAYLOR ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5508
Mailing Address - Country:US
Mailing Address - Phone:202-882-3624
Mailing Address - Fax:
Practice Address - Street 1:1338 TAYLOR ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5508
Practice Address - Country:US
Practice Address - Phone:202-882-3624
Practice Address - Fax:202-291-0856
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant