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Individual

MS. VANESSA WYCHE GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, MSN, RN, LPC

Contact information

Practice address
4115 COLUMBIA RD STE 5 PMB 205, MARTINEZ, GA 30907-0405
(706) 799-7972
Mailing address
4115 COLUMBIA RD STE 5 PMB 205, MARTINEZ, GA 30907-0405
(706) 799-7972

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC015606
GA
163W00000X
Registered Nurse
RN102766
GA

Other

Enumeration date
08/14/2018
Last updated
07/04/2025
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