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1366136202
GLORIA MAE GRAHAM
SAN DIEGO, CA
NPI
1366136202
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 11499)
Enumeration Date
2023-06-05
Last Update Date
2023-07-14
Business Address
GLORIA MAE GRAHAM SUDCC III
2535 CAMINO DEL RIO S STE 100
SAN DIEGO, CA 92108-3754
Phone number: 619-558-6102
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Mailing Address
GLORIA MAE GRAHAM SUDCC III
118 14TH ST APT 47
RAMONA, CA 92065-2149
Phone number: 619-559-6102
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