| Nicole Graham Phd Pa | |
|
12 Se 7th St Ste 705 Fort Lauderdale FL 33301-3469 | |
| (954) 365-5366 | |
| Not Available |
| Full Name | Nicole Graham Phd Pa |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 12 Se 7th St Ste 705, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Nicole Graham (PRESIDENT) |
| Authorized Official Contact | 9543655366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Graham Phd Pa 12 Se 7th St Ste 705 Fort Lauderdale FL 33301-3469 Ph: (954) 365-5366 | Nicole Graham Phd Pa 12 Se 7th St Ste 705 Fort Lauderdale FL 33301-3469 Ph: (954) 365-5366 |
| NPI Number | 1427664176 |
|---|---|
| Provider Enumeration Date | 09/18/2020 |
| Last Update Date | 12/02/2024 |
| Certification Date | 12/02/2024 |
| Medicare PECOS PAC ID | 9335569284 |
|---|---|
| Medicare Enrollment ID | O20201015001266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427664176 | NPI | - | NPPES |
| Provider Name | Nicole Graham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568742435 PECOS PAC ID: 7012337967 Enrollment ID: I20201015001577 |
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