Individual
MRS. CLARISSA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8106 FLINTWOOD CT, NORTH CHARLESTON, SC 29406-9435
(843) 593-1048
Mailing address
PO BOX 57, NESMITH, SC 29580-0057
(843) 593-1048
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
RBS60998
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019
—
SC
Enumeration date
03/20/2019
Last updated
03/20/2019
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