Individual
THERESA ANN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
880 82ND DR, GLADSTONE, OR 97027-1803
(503) 659-5515
(503) 659-1994
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 233-5405
(503) 233-2692
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH00011236
WA
101YP2500X
Professional Counselor
Primary
C2127
OR
Other
Enumeration date
11/03/2009
Last updated
12/29/2010
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