Individual
DOMINIQUE B GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
850 HARRISON AVE, DOWLING 9, BOSTON, MA 02118-4001
(617) 414-4230
(617) 414-4248
Mailing address
850 HARRISON AVE, BOSTON, MA 02118-4001
(617) 414-4230
(617) 414-4248
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/25/2009
Last updated
01/20/2012
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