Individual
BROOKE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
136 FAIRVIEW RD STE 125, MOORESVILLE, NC 28117-8547
(704) 667-7635
(980) 435-0398
Mailing address
206 N JACKSON ST STE 202, GLENDALE, CA 91206-4330
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A17396
NC
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/23/2018
Last updated
06/07/2022
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