Provider Demographics
NPI:1407006950
Name:GRAHAM, JENNIFER NORTON (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:NORTON
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 SAINT ELMO AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-6066
Mailing Address - Country:US
Mailing Address - Phone:240-401-3252
Mailing Address - Fax:
Practice Address - Street 1:4948 SAINT ELMO AVE STE 206
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6066
Practice Address - Country:US
Practice Address - Phone:301-652-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-21
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist