Provider Demographics
NPI:1871913517
Name:GRAHAM-FOXE, YAKIA (PT)
Entity type:Individual
Prefix:
First Name:YAKIA
Middle Name:
Last Name:GRAHAM-FOXE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 JAVELIN CIR
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:SC
Mailing Address - Zip Code:29541-4441
Mailing Address - Country:US
Mailing Address - Phone:843-615-6301
Mailing Address - Fax:843-308-1884
Practice Address - Street 1:2619 JAVELIN CIR
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:SC
Practice Address - Zip Code:29541-4441
Practice Address - Country:US
Practice Address - Phone:843-615-6301
Practice Address - Fax:843-308-1884
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC82332251X0800X
KYPT-006101225100000X
SCPT. 8233 PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic