| Doctor Name: | MATTHEW GRAHAM |
| NPI Number: | 1265400949 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | 39001757A |
| Business Practice Address: | 5233 S 50 E White's Institute Wabash, IN - 469928011 |
| Business Phone Number: | 2605631158 |
| Business Fax Number: | 2605638975 |
| Mailing Address: | 850 N Harrison St, Otis R. Bowen Center WARSAW |
| State: | IN |
| Postal Code: | 465803163 |
| Phone Number: | 5742677169 |
| Fax Number: | 5742693995 |
| NPI Enumeration Date: | 03/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 39001757A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |