Individual
MS. SANDRA DECOURSEY GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
4545 N 36TH ST STE 102, PHOENIX, AZ 85018-3473
(928) 232-9195
Mailing address
PO BOX 20045, WICKENBURG, AZ 85358-5045
(928) 232-9195
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-13806
AZ
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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