Individual
EDA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2025 ROUTE 9W, RAVENA, NY 12143
(518) 935-8258
Mailing address
21 PARK LN S APT 2, MENANDS, NY 12204-1940
(518) 935-8258
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
117708
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117708
—
NY
Enumeration date
10/14/2022
Last updated
10/14/2022
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