Individual
MR. GREGORY SCOTT GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1098 WILD HILL RD, FAIRLEE, VT 05045-9525
(802) 380-1026
Mailing address
1098 WILD HILL RD, FAIRLEE, VT 05045-9525
(802) 380-1026
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000090
VT
Other
Enumeration date
12/20/2010
Last updated
12/20/2010
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