| NPI | 1770832859 |
|---|---|
| Former Name | GLORIA LEA GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW16411) |
| Additional Taxonomies | 104100000X Social Worker |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2022-07-21 |