Individual
MS. CAPRICE DORLEE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, BCCR
Contact information
Practice address
297 CENTURY AVE S, MAPLEWOOD, MN 55119-5206
(651) 266-1496
(651) 266-1468
Mailing address
297 CENTURY AVE S, MAPLEWOOD, MN 55119-5206
(651) 266-1496
(651) 266-1468
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301710
MN
Other
Enumeration date
04/06/2011
Last updated
04/06/2011
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