Individual
LAURA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
836 N 1375 W, PROVO, UT 84604-3049
(801) 375-2523
Mailing address
25 E 200 N APT M, OREM, UT 84057-4767
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
UT
101Y00000X
Counselor
—
—
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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