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Individual

MR. ALL'WYN DALE GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NCC LPC SAP ADC

Contact information

Practice address
4011 MERIDIAN ST, NORMAL, AL 35762-5312
(256) 372-4751
(256) 372-5599
Mailing address
2251 HELTON DR, APT E5, FLORENCE, AL 35630-1084
(256) 348-8131

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20238
AL
101YA0400X
Addiction (Substance Use Disorder) Counselor
524
AL
101YP2500X
Professional Counselor
Primary
2942
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20238
SAP
01
2942
LPC
AL
Enumeration date
03/17/2011
Last updated
12/13/2012
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