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Individual

MR. KEVIN EUGENE GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LCAS

Contact information

Practice address
117 CHARLES ST, LUMBERTON, NC 28358-4538
(910) 241-9108
Mailing address
117 CHARLES ST, LUMBERTON, NC 28358-4538
(910) 241-9108

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2915
NC

Other

Enumeration date
12/31/2012
Last updated
04/28/2016
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