Provider Demographics
NPI:1669655510
Name:GRAHAM, CATHERINE G (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:G
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 IRON BARK CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2976
Mailing Address - Country:US
Mailing Address - Phone:610-551-9157
Mailing Address - Fax:
Practice Address - Street 1:119 IRON BARK CT
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-2976
Practice Address - Country:US
Practice Address - Phone:610-551-9157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist