Individual
PAUL/VIV GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
12836 LOMAS BLVD NE STE C, ALBUQUERQUE, NM 87112-6200
(505) 710-6530
Mailing address
12836 LOMAS BLVD NE STE C, ALBUQUERQUE, NM 87112-6200
(505) 710-6530
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2024-0565
NM
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/01/2022
Last updated
06/13/2024
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