Provider Demographics
NPI:1790913119
Name:GRAHAM, KATY ELIZABETH (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATY
Middle Name:ELIZABETH
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 REMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-8202
Mailing Address - Country:US
Mailing Address - Phone:501-850-8788
Mailing Address - Fax:501-850-8791
Practice Address - Street 1:5 REMINGTON DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-8202
Practice Address - Country:US
Practice Address - Phone:501-850-8788
Practice Address - Fax:501-850-8791
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP2879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist