Individual
MERIDITH TARA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW CP
Contact information
Practice address
520 THURGOOD MARSHALL HWY, KINGSTREE, SC 29556-4108
(843) 355-5628
(843) 667-1362
Mailing address
360 N IRBY ST, FLORENCE, SC 29501-2808
(843) 667-9414
(843) 667-1362
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
11435
SC
1041C0700X
Clinical Social Worker
Primary
11435
SC
Other
Enumeration date
11/06/2017
Last updated
01/07/2020
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