Individual
ASHLEY GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
239 SW ARMAND PL, LAKE CITY, FL 32025-2608
(352) 301-6163
Mailing address
239 SW ARMAND PL, LAKE CITY, FL 32025-2608
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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