Individual
BRUCE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
98 YORK ST, YALE CHILD STUDY CENTER IICAPS, NEW HAVEN, CT 06511
(203) 464-7721
(203) 785-6860
Mailing address
98 YORK ST, YALE CHILD STUDY CENTER IICAPS, NEW HAVEN, CT 06511
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
009710
CT
1041C0700X
Clinical Social Worker
Primary
009710
CT
Other
Enumeration date
05/29/2018
Last updated
10/26/2018
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