Individual
NICOLE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1091 BROAD STREET, NEWARK, NJ 07114
(973) 623-0600
Mailing address
103 LINCOLN PARK, NEWARK, NJ 07102-2391
(973) 623-0600
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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