Provider Demographics
NPI:1053047175
Name:GRAHAM, LENAY JENNIFER (CD, CLD)
Entity Type:Individual
Prefix:
First Name:LENAY
Middle Name:JENNIFER
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:CD, CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 COUNTY RD W
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-9658
Mailing Address - Country:US
Mailing Address - Phone:262-389-0230
Mailing Address - Fax:
Practice Address - Street 1:W63N128 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-2725
Practice Address - Country:US
Practice Address - Phone:262-389-0230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty