Individual
MR. SHAWN EDWARD GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC5036
ME
101YP2500X
Professional Counselor
Primary
CC5145
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740476159
—
ME
Enumeration date
11/26/2012
Last updated
10/03/2019
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