| NPI | 1356877245 |
|---|---|
| Other Name | MANDY JEAN GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 291034) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-03-10 |