Individual
TERRENCE WAYNE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LCAS
Contact information
Practice address
2113 SWIMMING HOLE CIR, RALEIGH, NC 27610-5377
(919) 623-4059
Mailing address
PO BOX 46043, RALEIGH, NC 27620-6043
(919) 268-0968
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1222
NC
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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