Shavontai Graham, CCC-SLP
Speech-Language Pathologist, in Atlanta, GA. Individual provider (NPI-1).
NPI number1194459800
StatusActive
Last updated in NPPESMay 15, 2024
Details
- NPI
- 1194459800
- Entity type
- Individual (NPI-1)
- Name
- Shavontai Graham
- Credential
- CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 11, 2022
- Certification date
- May 15, 2024
- Last updated
- May 15, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | SLP012857 | GA | Yes |
Practice location
2150 Southwood Cv Sw Unit 131Atlanta, GA 30331-5880
Phone 803-342-0283
Mailing address
2150 Southwood Cv Sw Unit 131Atlanta, GA 30331-5880
Phone 803-342-0283
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