Doctor Name: | ANN GRAHAM |
NPI Number: | 1013079508 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0904001715 |
Business Practice Address: | 2244 Executive Dr Hampton, VA - 236662430 |
Business Phone Number: | 7578271001 |
Business Fax Number: | |
Mailing Address: | 117 Botetourt Rd, NEWPORT NEWS |
State: | VA |
Postal Code: | 236013601 |
Phone Number: | 7575994566 |
Fax Number: | |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904001715 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |