Doctor Name: | ANGELA GRAHAM |
NPI Number: | 1497031801 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 8746 |
Business Practice Address: | 3021 Running Brook Dr Joshua, TX - 760585757 |
Business Phone Number: | 8174804951 |
Business Fax Number: | |
Mailing Address: | 3021 Running Brook Dr, JOSHUA |
State: | TX |
Postal Code: | 760585757 |
Phone Number: | 8174804951 |
Fax Number: | |
NPI Enumeration Date: | 10/30/2011 |
NPI Last Update Date: | 10/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 8746 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |