| Doctor Name: | SHAWN GRAHAM |
| NPI Number: | 1033566674 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 6401007096 |
| Business Practice Address: | 1255 N Oakland Blvd Waterford, MI - 483271545 |
| Business Phone Number: | 2484060090 |
| Business Fax Number: | |
| Mailing Address: | 820 Edenbough Cir Apt 103, AUBURN HILLS |
| State: | MI |
| Postal Code: | 483264547 |
| Phone Number: | 2484642500 |
| Fax Number: | |
| NPI Enumeration Date: | 05/24/2016 |
| NPI Last Update Date: | 05/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 6401007096 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |