Individual
MS. ALICIA LYNN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
22251 STATE ROUTE 2, ARCHBOLD, OH 43502-9452
(419) 445-1552
(419) 445-1401
Mailing address
17420 COUNTY ROAD 17F, BRYAN, OH 43506-9446
(419) 310-9524
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
S.0500348
OH
104100000X
Social Worker
I.0800184
OH
1041C0700X
Clinical Social Worker
Primary
I.0800184-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166914
—
OH
05
—
1790976744
—
OH
Enumeration date
08/06/2007
Last updated
11/04/2024
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