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Mrs. Tracie Renee Graham, OT
Specialist in West Memphis, Arkansas
NPI 1265550875

Tracie Renee Graham is a Specialist based in Memphis, AR. Tracie Renee Graham practices in West Memphis, AR and has the professional credentials of OT. The NPI Number for Tracie Renee Graham is 1265550875 and holds a License No. OTR1280 (Arkansas).

The current practice location address for Tracie Renee Graham is 413 W. Tyler Cove, West Memphis, AR and can be reached out via phone at 870-733-1200 and via fax at 870-732-3269.

Location: 413 W. Tyler Cove, West Memphis, AR, 38125-5700
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265550875
Provider Name
Tracie Renee Graham
Credential
OT
Provider Entity Type
Individual
Gender
Female
Address
413 W. Tyler Cove, West Memphis, AR, 38125-5700
Phone Number
870-733-1200
Fax Number
870-732-3269
Provider Enumeration Date
03/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5U518 01 AR AR BLUECROSS BLUESHIELD
institution
Provider Business Practice Location Address Details
Address
413 W. Tyler Cove
City
West Memphis
State
Arkansas
Zip
72301
Phone Number
870-733-1200
Fax Number
870-732-3269
person
Provider Business Mailing Address Details
Address
413 W. Tyler Cove
City
West Memphis
State
Arkansas
Zip
72301
Phone Number
870-733-1200
Fax Number
870-732-3269
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
OTR1280 (Arkansas)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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