Individual
JACQUELINE RENEE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
124 S 400 E, SUITE 450, SALT LAKE CITY, UT 84111-2135
(801) 326-7444
(801) 783-5559
Mailing address
124 S 400 E, SUITE 450, SALT LAKE CITY, UT 84111-2135
(801) 326-7444
(801) 783-5559
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2089903502
UT
Other
Enumeration date
03/15/2006
Last updated
09/27/2010
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