Individual
MANDILYN RENICE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
7770 PAINT CREEK DR, YPSILANTI, MI 48197-6139
(773) 301-3640
Mailing address
17485 EASTGATE DR, COUNTRY CLUB HILLS, IL 60478-4640
(773) 301-3640
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.009581
IL
101YP2500X
Professional Counselor
6401222749
MI
Other
Enumeration date
09/28/2017
Last updated
02/16/2023
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