Provider Demographics
NPI:1144409335
Name:GRAHAM, ROBERT D
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10155 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2063
Mailing Address - Country:US
Mailing Address - Phone:562-692-0383
Mailing Address - Fax:562-692-0380
Practice Address - Street 1:10155 COLIMA RD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2063
Practice Address - Country:US
Practice Address - Phone:562-692-0383
Practice Address - Fax:562-692-0380
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker