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1790380814
NICOLE WANDA GRAHAM
REDDING, CA
NPI
1790380814
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-12-04
Last Update Date
2020-12-04
Business Address
NICOLE WANDA GRAHAM
3648 EL PORTAL DR
REDDING, CA 96002-3133
Phone number: 530-722-1114
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Mailing Address
NICOLE WANDA GRAHAM
3648 EL PORTAL DR
REDDING, CA 96002-3133
Phone number: 530-722-1114
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