Provider Demographics
NPI:1285868661
Name:GRAHAM, PATRICIA LYNN (MS SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNN
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W HURD ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5312
Mailing Address - Country:US
Mailing Address - Phone:405-990-5304
Mailing Address - Fax:
Practice Address - Street 1:415 W HURD ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5312
Practice Address - Country:US
Practice Address - Phone:405-990-5304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist