| Doctor Name: | MR. ALL'WYN DALE GRAHAM |
| NPI Number: | 1043519903 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NCC LPC SAP ADC |
| License Number: | 20238 |
| Business Practice Address: | 4011 Meridian St Normal, AL - 357625312 |
| Business Phone Number: | 2563724751 |
| Business Fax Number: | 2563725599 |
| Mailing Address: | 2251 Helton Dr, Apt E5 FLORENCE |
| State: | AL |
| Postal Code: | 356301084 |
| Phone Number: | 2563488131 |
| Fax Number: | |
| NPI Enumeration Date: | 03/17/2011 |
| NPI Last Update Date: | 12/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 20238 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |