Provider Demographics
NPI:1376663138
Name:GRAHAM, L KRISTI (MA/LADC)
Entity Type:Individual
Prefix:MS
First Name:L
Middle Name:KRISTI
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MA/LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8181 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-1182
Mailing Address - Country:US
Mailing Address - Phone:918-852-3304
Mailing Address - Fax:
Practice Address - Street 1:8181 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-1182
Practice Address - Country:US
Practice Address - Phone:918-852-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)