Individual
MR. JOHN ELLINGTON GRAHAM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, MSED
Contact information
Practice address
300 FORT ZUMWALT SQ, SUITE 107, O FALLON, MO 63366-3078
(636) 980-4673
(636) 625-8284
Mailing address
13 POINTER CT, LAKE ST LOUIS, MO 63367-2017
(636) 485-2900
(636) 625-8284
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001763
MO
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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