Nicole Graham, PHD is a
Clinical Neuropsychologist based in Fort Lauderdale, Florida. Nicole Graham is licensed to practice in Florida (license number PY10889) and her current practice location is
12 Se 7th St Ste 705, Fort Lauderdale, Florida. She can be reached at her office (for appointments etc.) via phone at
(954) 365-5366.
NPI number for Nicole Graham is 1568742435 and her current mailing address is 12 Se 7th St Ste 705, Fort Lauderdale, Florida. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1568742435.
Healthcare Provider's Profile
| Full Name | Nicole Graham |
|---|
| Gender | Female |
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| Speciality | Clinical Neuropsychologist |
|---|
| Location | 12 Se 7th St Ste 705, Fort Lauderdale, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1568742435
- Provider Enumeration Date: 08/24/2011
- Last Update Date: 12/02/2024
Medical Identifiers
Medical identifiers for Nicole Graham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568742435 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | PY10889 (Florida) | Secondary |
| 103TC0700X | Psychologist - Clinical | PY10889 (Florida) | Secondary |
| 103TF0200X | Psychologist - Forensic | PY10889 (Florida) | Secondary |
| 103G00000X | Clinical Neuropsychologist | PY10889 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Graham is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Nicole Graham, PHD
12 Se 7th St Ste 705,
Fort Lauderdale, FL 33301-3469
Ph: (954) 365-5366 | Nicole Graham, PHD
12 Se 7th St Ste 705,
Fort Lauderdale, FL 33301-3469
Ph: (954) 365-5366 |
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