Individual
MRS. CANDICE LEIGH GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2153 E JOYCE BLVD, SUITE 201, FAYETTEVILLE, AR 72703-4714
(479) 575-9471
Mailing address
2408 E ELAINE AVE, FAYETTEVILLE, AR 72703-4509
(479) 283-3979
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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