Graham, Samuel Lee

Graham, Samuel Lee is an individual health care provider with primary practice located at 1000 73Rd St , Windsor Heights IA 50311-1321. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Graham, Samuel Lee can be contacted via phone (515) 222-1175.

Contact Information

Primary practice address
1000 73Rd St Windsor Heights IA 50311-1321
Phone: (515) 222-1175
Fax: (515) 222-0953
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 435/160 Iowa

Profile Details

NPI number 1730181447
LBN Legal business name Graham, Samuel Lee
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730181447 NPPES
Iowa MEDICAID 421355536-26

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