Provider Demographics
NPI:1194371385
Name:GRAHAM, ABIGAIL J
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:J
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 1:5 CARTER RD
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:TN
Mailing Address - Zip Code:38488-5054
Mailing Address - Country:US
Mailing Address - Phone:256-668-1422
Mailing Address - Fax:
Practice Address - Street 1:2400 WHITE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2235
Practice Address - Country:US
Practice Address - Phone:615-460-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker