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Individual

BRYANNA ELYCE GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
101 NEW YORK AVE, FORT WORTH, TX 76104-1558
(817) 313-4017
Mailing address
5529 SHORE POINT TRL, FORT WORTH, TX 76119-7026
(682) 359-8114

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6906-C
AR
1041C0700X
Clinical Social Worker
149020092
IL
1041C0700X
Clinical Social Worker
6906-C
AR
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
06/20/2013
Last updated
02/11/2023
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