Individual
TIMOTHY ASHLEY GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(704) 332-9001
Mailing address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(704) 332-9001
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25665
NC
Other
Enumeration date
04/25/2021
Last updated
04/25/2021
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