| Ona Graham Psy D, Pc | |
|
1443 17th St Columbus GA 31901-2029 | |
| (706) 317-2163 | |
| (706) 317-2176 |
| Full Name | Ona Graham Psy D, Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1443 17th St, Columbus, Georgia |
| Authorized Official Name and Position | Ona Graham (OWNER/PRESIDENT) |
| Authorized Official Contact | 7063172163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ona Graham Psy D, Pc 1443 17th St Columbus GA 31901-2029 Ph: (706) 317-2163 | Ona Graham Psy D, Pc 1443 17th St Columbus GA 31901-2029 Ph: (706) 317-2163 |
| NPI Number | 1952583106 |
|---|---|
| Provider Enumeration Date | 11/29/2007 |
| Last Update Date | 11/29/2007 |
| Medicare PECOS PAC ID | 6507945409 |
|---|---|
| Medicare Enrollment ID | O20080505000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952583106 | NPI | - | NPPES |
| 00897124B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY001682 (Georgia) | Primary |
| Provider Name | Ona Graham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578597126 PECOS PAC ID: 4688639149 Enrollment ID: I20041123000981 |
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