| NPI | 1154476166 |
|---|---|
| Former Name | CAROL M GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B1-0000719) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: DE B1-0000719) |
| 103TC0700X Psychologist, Clinical (Licence: PA PS015843) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-10-25 |