Individual
DR. SAMANTHA LYNN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DRPH, CBHCMS
Contact information
Practice address
9951 ATLANTIC BLVD STE 319, JACKSONVILLE, FL 32225-6577
(904) 990-4211
Mailing address
9951 ATLANTIC BLVD STE 319, JACKSONVILLE, FL 32225-6577
(904) 990-4211
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
CBHCM.0105764
FL
171M00000X
Case Manager/Care Coordinator
Primary
CBHCMS.0102666
FL
Other
Enumeration date
01/25/2024
Last updated
09/13/2024
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