Provider Demographics
NPI:1760855142
Name:GRAHAM, KARA RENEE (MS CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:RENEE
Last Name:GRAHAM
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Gender:F
Credentials:MS CCC/SLP
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Mailing Address - Street 1:2701 N ROCKY POINT DR
Mailing Address - Street 2:SUITE 650
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5917
Mailing Address - Country:US
Mailing Address - Phone:813-549-5834
Mailing Address - Fax:800-892-0648
Practice Address - Street 1:2701 N ROCKY POINT DR
Practice Address - Street 2:SUITE 650
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5917
Practice Address - Country:US
Practice Address - Phone:813-549-5834
Practice Address - Fax:800-892-0648
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL146.012668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist