Provider Demographics
NPI:1942052808
Name:GRAF, PATRICIA MARIE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:GRAF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 DETROIT AVE APT 220
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-1888
Mailing Address - Country:US
Mailing Address - Phone:216-727-7252
Mailing Address - Fax:
Practice Address - Street 1:8301 DETROIT AVE APT 220
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-1888
Practice Address - Country:US
Practice Address - Phone:216-727-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.004385175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist