Individual
NICOLE MORGAN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
123 ANDOVER RD, WESTBROOK, ME 04092-3848
(207) 661-6252
Mailing address
1789 PORTLAND RD, ARUNDEL, ME 04046-7938
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2759
NH
225XM0800X
Mental Health Occupational Therapist
Primary
OT3780
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2759
OCCUPATIONAL THERAPIST LICENSE NH
NH
01
—
OT3780
OCCUPATIONAL THERAPY LICENSE ME
ME
Enumeration date
08/13/2018
Last updated
03/03/2022
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