Individual
ANDREA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1607 ROUTE 300 STE 115, NEWBURGH, NY 12550-1738
(845) 320-5942
Mailing address
470 ROUTE 211EAST STE 24 #1110, MIDDLETOWN, NY 10940
(845) 320-5942
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
095281-01
NY
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
094835
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
N/A
—
Enumeration date
01/21/2021
Last updated
06/30/2023
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