Provider Demographics
NPI:1770828402
Name:GRAHAM, KAI (SLP)
Entity Type:Individual
Prefix:MISS
First Name:KAI
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-2937
Mailing Address - Country:US
Mailing Address - Phone:918-852-3607
Mailing Address - Fax:
Practice Address - Street 1:606 W 34TH ST
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-2937
Practice Address - Country:US
Practice Address - Phone:918-852-3607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist