Provider Demographics
NPI:1033582481
Name:OBRIAN, KATHERINE GRAHAM
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:GRAHAM
Last Name:OBRIAN
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 1:5956 E PIMA ST STE 140
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4385
Mailing Address - Country:US
Mailing Address - Phone:520-885-0234
Mailing Address - Fax:520-885-0234
Practice Address - Street 1:5956 E PIMA ST STE 140
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4385
Practice Address - Country:US
Practice Address - Phone:520-885-0234
Practice Address - Fax:520-885-0234
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTHAD237700000X
AZHADE9284237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist