Individual
DWAYNE A GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
73 LENOX AVE, NEW YORK, NY 10026-3007
(212) 663-1975
Mailing address
81 DUELK AVE, MONROE, NY 10950-2021
(347) 233-9694
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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