Provider Demographics
NPI:1487226650
Name:MALINDA GRAHAM & ASSOCIATES
Entity Type:Organization
Organization Name:MALINDA GRAHAM & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:EMMIT
Authorized Official - Last Name:LOVELACE
Authorized Official - Suffix:III
Authorized Official - Credentials:MS, ST
Authorized Official - Phone:191-265-5947
Mailing Address - Street 1:8400 ABERCORN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3425
Mailing Address - Country:US
Mailing Address - Phone:912-655-9472
Mailing Address - Fax:
Practice Address - Street 1:8400 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3425
Practice Address - Country:US
Practice Address - Phone:912-655-9472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)