Individual
DR. ETHAN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
330 W 58TH ST STE 405, NEW YORK, NY 10019-1820
(718) 702-2437
Mailing address
320 7TH AVE # 330, BROOKLYN, NY 11215-4194
(718) 702-2437
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
018415
NY
Other
Enumeration date
07/14/2010
Last updated
02/02/2021
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