Individual
LORRAINE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 N BROAD ST, RM 821, PHILADELPHIA, PA 19102-1510
(215) 568-0860
(215) 568-0769
Mailing address
2852 N VAN PELT ST, PHILADELPHIA, PA 19132-2643
(215) 223-4458
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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