Individual
MICHELLE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
2014 VANDALIA ST, COLLINSVILLE, IL 62234-4848
(618) 345-9536
(618) 345-9587
Mailing address
2014 VANDALIA ST, COLLINSVILLE, IL 62234-4848
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.014125
IL
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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